Correlation of Global Longitudinal Strain with Functional Status of Patients with Left Ventricular Systolic Dysfunction

Abstract

Background: Two-dimensional (2D) left ventricular ejection fraction (LVEF) is a well-known parameter to assess the functional status of the patients. Recently, global longitudinal strain (GLS) has emerged as a more sensitive tool for assessing left ventricular (LV) systolic function. We aimed to assess the superiority of GLS by 2D speckle-tracking echocardiography over 2D LVEF in patients with moderate-to-severe LV systolic dysfunction (LVSD) calculated using Simpson's biplane method of disks, in predicting the functional status of the patients. Materials and Methods: One hundred patients in age group 18–80 years with moderate-to-severe LVSD (2D LVEF <40%) were included. New York Heart Association class 4 patients and patients of rheumatic heart disease or valvular heart disease were excluded. 2D LVEF was calculated using Simpson's method. 2D GLS was assessed using automated function imaging technique. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to assess functional status of patients with moderate-to-severe LVSD. Results: Results showed that 2D GLS better correlated with functional status of the patients (P ≤ 0.0001) than 2D LVEF (P = 0.619). Patients who had better 2D GLS had better functional status according to MLHFQ. Conclusion: Correlation of functional status of patients with poor LVSD was superior with 2D GLS when compared to 2D LVEF. Since strain imaging is an inexpensive tool, it can be easily applied to assess functional status in large number of patients without adding any additional cost.

Keywords

• global longitudinal strain
• left ventricular ejection fraction
• speckle-tracking echocardiography