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Left Ventricular Global Longitudinal Strain Is Associated With Cardiovascular Outcomes in Patients Who Underwent Permanent Pacemaker Implantation

Authors
 Dae-Young Kim  ;  Purevjargal Lkhagvasuren  ;  Jiwon Seo  ;  Iksung Cho  ;  Geu-Ru Hong  ;  Jong-Won Ha  ;  Chi Young Shim 
Citation
 FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol.8 : 705778, 2021-07 
Journal Title
FRONTIERS IN CARDIOVASCULAR MEDICINE
Issue Date
2021-07
Keywords
cardiomyopahty ; left ventricular ejection fraction (LVEF) ; left ventricular global longitudinal strain ; outcome ; pacemaker
Abstract
Background: Patients who underwent permanent pacemaker (PM) implantation have a potential risk of left ventricular (LV) systolic dysfunction. However, assessment of LV ejection fraction (LVEF) shows a limited role in identifying subclinical LV systolic dysfunction and predicting cardiovascular (CV) outcomes. Methods: We reviewed 1,103 patients who underwent permanent PM implantation between January 2007 and December 2017. After excluding patients who did not undergo echocardiograms before or after PM implantation and those with LV ejection fraction (LVEF) <50%, significant valve dysfunction, and history of cardiac surgery before PM implantation, 300 (67 ± 13 years, 119 men) were finally analyzed. LV mechanical function was assessed with LV global longitudinal strain (LV-GLS) using 2-dimensional speckle-tracking echocardiography. CV outcomes were defined as a composite of CV death and hospitalization for heart failure. Results: At 44 ± 28 months after post-PM echocardiogram, 23 patients (7.7%) had experienced CV outcomes. Patients with CV outcomes were older and had more comorbidities and a lower baseline
LV-GLS
than those without CV outcomes. LV mechanical function worsened after PM implantation in patients with CV outcomes. The cut-off value of 11.2% in
LV-GLS
on post-PM echocardiogram had a better predictive value for CV outcomes (AUC; 0.784 vs. 0.647, p = 0.012). CV outcome in patients with
LV-GLS
<11.2% was worse than that in those with
LV-GLS
≥ 11.2% (log-rank p < 0.001). Multivariate Cox model revealed that reduced
LV-GLS
was independently associated with CV outcomes. Conclusions: Pacing deteriorates LV mechanical function. Impaired LV-GLS is associated with poor CV outcomes in patients who underwent PM implantation.
Files in This Item:
T202103628.pdf Download
DOI
10.3389/fcvm.2021.705778
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae-Young(김대영)
Suh, Jee Won(서지원) ORCID logo https://orcid.org/0000-0003-0287-0651
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Cho, Ik Sung(조익성)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/184765
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