Potential Prognostic Relevance of Left-Ventricular Global Longitudinal Strain and of the Summation of the Mitral and Tricuspid Regurgitation Volume in Patients with Non-Ischemic Dilated Cardiomyopathy

Background: The aim of this pilot study was to determine the potential prognostic relevance of novel multidirectional myocardial and volumetric echocardiographic parameters in patients with non-ischemic dilated cardiomyopathy (NIDCM). Methods: Multidirectional myocardial parameters (longitudinal, ra...

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Main Authors: Karolina Mėlinytė-Ankudavičė, Eglė Ereminienė, Vaida Mizarienė, Gintarė Šakalytė, Jurgita Plisienė, Renaldas Jurkevičius
Format: Article
Language:English
Published: MDPI AG 2023-09-01
Series:Journal of Cardiovascular Development and Disease
Subjects:
Online Access:https://www.mdpi.com/2308-3425/10/10/410
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author Karolina Mėlinytė-Ankudavičė
Eglė Ereminienė
Vaida Mizarienė
Gintarė Šakalytė
Jurgita Plisienė
Renaldas Jurkevičius
author_facet Karolina Mėlinytė-Ankudavičė
Eglė Ereminienė
Vaida Mizarienė
Gintarė Šakalytė
Jurgita Plisienė
Renaldas Jurkevičius
author_sort Karolina Mėlinytė-Ankudavičė
collection DOAJ
description Background: The aim of this pilot study was to determine the potential prognostic relevance of novel multidirectional myocardial and volumetric echocardiographic parameters in patients with non-ischemic dilated cardiomyopathy (NIDCM). Methods: Multidirectional myocardial parameters (longitudinal, radial, and circumferential left-ventricular (LV) strain using speckle tracking echocardiography) and a new volumetric parameter (the sum of the mitral and tricuspid regurgitation volume (mitral–tricuspid regurgitation volume) were assessed. The cardiovascular (CV) outcome was a composite of cardiac death and hospitalization for heart failure (HF) at 1 year. Results: Approximately 102 patients were included in this pilot study. The mean LV ejection fraction (LVEF) was 28.4 ± 8.9%. During a follow-up of 1 year, the CV outcome occurred in 39 patients (10 HF deaths, and 36 hospitalizations for HF). The LV global longitudinal systolic strain (GLS) and mitral–tricuspid regurgitation volume were the main parameters that were seen to be significantly altered in the comparison of patients with events vs. those without events (GLS (absolute values) 7.4 ± 2.7% vs. 10.3 ± 2.6%; mitral–tricuspid regurgitation volume 61.1 ± 20.4 mL vs. 40.9 ± 22.9 mL, respectively; <i>p</i>-value < 0.01). In line with these findings, in a multivariate continuous logistic regression analysis, the GLS and mitral–tricuspid regurgitation volume were the main parameters associated with worse CV outcomes (GLS: OR 0.77 (95%CI 0.65–0.92); mitral–tricuspid regurgitation volume OR 1.09 (95%CI 1.01–1.25)), whereas the radial and circumferential LV global strain and mitral regurgitation volume and tricuspid regurgitation volume were not linked to the CV outcome. Furthermore, in a receiver operating characteristic curve analysis, a GLS cutoff of <7.5% and mitral–tricuspid regurgitation volume > 60 mL were the identified values for the parameters associated with worse CV outcomes. Conclusions: The findings of this pilot study suggest that the GLS and a novel volumetric parameter (the sum of the mitral and tricuspid regurgitation volume) are linked to worse CV outcomes in patients with non-ischemic dilated cardiomyopathy. Hence, these promising results warrant further validation in larger studies.
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spelling doaj.art-05219c68060940c398266fcec006616a2023-11-19T16:50:34ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-09-01101041010.3390/jcdd10100410Potential Prognostic Relevance of Left-Ventricular Global Longitudinal Strain and of the Summation of the Mitral and Tricuspid Regurgitation Volume in Patients with Non-Ischemic Dilated CardiomyopathyKarolina Mėlinytė-Ankudavičė0Eglė Ereminienė1Vaida Mizarienė2Gintarė Šakalytė3Jurgita Plisienė4Renaldas Jurkevičius5Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, LithuaniaDepartment of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, LithuaniaDepartment of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, LithuaniaDepartment of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, LithuaniaDepartment of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, LithuaniaDepartment of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, LithuaniaBackground: The aim of this pilot study was to determine the potential prognostic relevance of novel multidirectional myocardial and volumetric echocardiographic parameters in patients with non-ischemic dilated cardiomyopathy (NIDCM). Methods: Multidirectional myocardial parameters (longitudinal, radial, and circumferential left-ventricular (LV) strain using speckle tracking echocardiography) and a new volumetric parameter (the sum of the mitral and tricuspid regurgitation volume (mitral–tricuspid regurgitation volume) were assessed. The cardiovascular (CV) outcome was a composite of cardiac death and hospitalization for heart failure (HF) at 1 year. Results: Approximately 102 patients were included in this pilot study. The mean LV ejection fraction (LVEF) was 28.4 ± 8.9%. During a follow-up of 1 year, the CV outcome occurred in 39 patients (10 HF deaths, and 36 hospitalizations for HF). The LV global longitudinal systolic strain (GLS) and mitral–tricuspid regurgitation volume were the main parameters that were seen to be significantly altered in the comparison of patients with events vs. those without events (GLS (absolute values) 7.4 ± 2.7% vs. 10.3 ± 2.6%; mitral–tricuspid regurgitation volume 61.1 ± 20.4 mL vs. 40.9 ± 22.9 mL, respectively; <i>p</i>-value < 0.01). In line with these findings, in a multivariate continuous logistic regression analysis, the GLS and mitral–tricuspid regurgitation volume were the main parameters associated with worse CV outcomes (GLS: OR 0.77 (95%CI 0.65–0.92); mitral–tricuspid regurgitation volume OR 1.09 (95%CI 1.01–1.25)), whereas the radial and circumferential LV global strain and mitral regurgitation volume and tricuspid regurgitation volume were not linked to the CV outcome. Furthermore, in a receiver operating characteristic curve analysis, a GLS cutoff of <7.5% and mitral–tricuspid regurgitation volume > 60 mL were the identified values for the parameters associated with worse CV outcomes. Conclusions: The findings of this pilot study suggest that the GLS and a novel volumetric parameter (the sum of the mitral and tricuspid regurgitation volume) are linked to worse CV outcomes in patients with non-ischemic dilated cardiomyopathy. Hence, these promising results warrant further validation in larger studies.https://www.mdpi.com/2308-3425/10/10/410heart failurenon-ischemic dilated cardiomyopathy2D echocardiographyearly primary outcomes
spellingShingle Karolina Mėlinytė-Ankudavičė
Eglė Ereminienė
Vaida Mizarienė
Gintarė Šakalytė
Jurgita Plisienė
Renaldas Jurkevičius
Potential Prognostic Relevance of Left-Ventricular Global Longitudinal Strain and of the Summation of the Mitral and Tricuspid Regurgitation Volume in Patients with Non-Ischemic Dilated Cardiomyopathy
Journal of Cardiovascular Development and Disease
heart failure
non-ischemic dilated cardiomyopathy
2D echocardiography
early primary outcomes
title Potential Prognostic Relevance of Left-Ventricular Global Longitudinal Strain and of the Summation of the Mitral and Tricuspid Regurgitation Volume in Patients with Non-Ischemic Dilated Cardiomyopathy
title_full Potential Prognostic Relevance of Left-Ventricular Global Longitudinal Strain and of the Summation of the Mitral and Tricuspid Regurgitation Volume in Patients with Non-Ischemic Dilated Cardiomyopathy
title_fullStr Potential Prognostic Relevance of Left-Ventricular Global Longitudinal Strain and of the Summation of the Mitral and Tricuspid Regurgitation Volume in Patients with Non-Ischemic Dilated Cardiomyopathy
title_full_unstemmed Potential Prognostic Relevance of Left-Ventricular Global Longitudinal Strain and of the Summation of the Mitral and Tricuspid Regurgitation Volume in Patients with Non-Ischemic Dilated Cardiomyopathy
title_short Potential Prognostic Relevance of Left-Ventricular Global Longitudinal Strain and of the Summation of the Mitral and Tricuspid Regurgitation Volume in Patients with Non-Ischemic Dilated Cardiomyopathy
title_sort potential prognostic relevance of left ventricular global longitudinal strain and of the summation of the mitral and tricuspid regurgitation volume in patients with non ischemic dilated cardiomyopathy
topic heart failure
non-ischemic dilated cardiomyopathy
2D echocardiography
early primary outcomes
url https://www.mdpi.com/2308-3425/10/10/410
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