Prediction of Deterioration of Left Ventricular Function Using 3-Dimensional Speckle-Tracking Echocardiography in Patients With Left Bundle-Branch Blockopen access
- Authors
- Kim, H.M.; Hwang, I.-C.; Yoon, Y.E.; Park, J.-B.; Lee, S.-P.; Kim, H.-K.; Kim, Y.-J.; Lim, Yae Ji; Cho, G.-Y.
- Issue Date
- Jan-2023
- Publisher
- American Heart Association Inc.
- Keywords
- 3D echocardiography; left bundle-branch block; speckle-tracking echocardiography
- Citation
- Journal of the American Heart Association, v.12, no.1
- Journal Title
- Journal of the American Heart Association
- Volume
- 12
- Number
- 1
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/60595
- DOI
- 10.1161/JAHA.122.026194
- ISSN
- 2047-9980
2047-9980
- Abstract
- BACKGROUND: Previous studies have demonstrated that 2-dimensional (2D) global longitudinal strain (GLS) is associated with cardiovascular outcomes in patients with left bundle-branch block. However, the predictive value of 3-dimensional (3D) speckle-tracking echocardiography has not yet been investigated in these patients. METHODS AND RESULTS: The authors retrospectively identified 290 patients with left bundle-branch block who underwent echocardiography more than twice. Using speckle-tracking echocardiography, 2D-GLS, 3D-GLS, 3D-global circumferential strain, 3D global radial strain, and 3D global area strain were acquired. The association between 2D and 3D strains and the follow-up left ventricular (LV) ejection fraction (LVEF) was analyzed. The study population was divided into 2 sets: a group with preserved LVEF (baseline LVEF ≥40%) and a group with reduced LVEF (baseline LVEF <40%). After a median follow-up of 29.1 months (interquartile range, 13.1–53.0 months), 14.9% of patients progressed to LV dysfunction in the group with preserved LVEF, and 51.0% of patients showed improved LV function in the group with reduced LVEF. Multivariable analysis of 2D and 3D strains revealed that higher 2D-GLS (odds ratio [OR], 0.65 [95% CI, 0.54–0.78], P<0.001) was highly associated with maintaining LVEF in patients with preserved LVEF. However, a lower 3D-global circumferential strain (OR, 0.61 [95% CI, 0.47– 0.78], P<0.001) showed a strong association with persistently reduced LVEF in patients with reduced LVEF. CONCLUSIONS: Although 2D-GLS showed a powerful predictive value for the deterioration of LV function in the preserved LVEF group, 3D strain, especially 3D-global circumferential strain, can be helpful to predict consistent LV dysfunction in patients with left bundle-branch block who have reduced LVEF. © 2022 The Authors.
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