Left Ventricular Strain Predicts Heart Failure Admissions in African Americans with Heart Failure

Left ventricular global longitudinal strain (LV GLS) is a sensitive measure of LV mechanics that has been correlated with adverse events in patients with heart failure. Previous studies have included few African American (AA) patients. We enrolled 207 AA adults, age 56 ± 14.5 years, with New York heart Association (NYHA) class I through III HF on optimal guideline-directed medical therapy (GDMT) from the University of Illinois HF clinic between November 2001 and February 2014. LV GLS was assessed by velocity vector imaging using 2, 3 and 4-chamber views. Patients were followed for HF admissions and death for 3 ± 3.0 years. LV GLS value of -7.95 was used as the optimal cutoff point that maximizes sensitivity and specificity LV GLS >-7.95% was significantly associated with higher all-cause mortality and HF admissions in Kaplan-Meier survival curves (log-rank P<0.001). After incorporated in a multivariate Cox proportional hazard models, GLS > -7.95% was found to be an independent predictor of all-cause mortality (HR=4.20; 95% CI 1.14-15.56; p =0.014) and HF admissions (HR3.86; 95% CI 1.38-10.77; p =0.010). In AA patients with chronic stable HF on GDMT, more impaired LV GLS (>-7.95%) is a strong and independent predictor of long-term all-cause mortality and HF admission.