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Purpose <p>To determine the prognostic value of layer-specific global longitudinal strain (GLS) after coronary artery bypass grafting (CABG).</p> Methods <p>This retrospective cohort study comprised 641 patients undergoing isolated CABG between 2006 and 2011. Layer-specific GLS was assessed by echocardiography using two-dimensional speckle tracking. Patients were followed through nation-wide registries for all-cause mortality, heart failure (HF), and the composite endpoint of HF or cardiovascular death (CVD) (HF/CVD).</p> Results <p>During follow-up (3.8 years [IQR: 2.7; 4.9]), 73 patients died, and 62 developed HF/CVD (HF: <i>n</i> = 30, CVD: <i>n</i> = 38). Patients who died had reduced GLS in all layers; GLSendo (–14.2% vs. − 16.3%, <i>p</i> &lt; 0.001), whole wall GLS (–12.1% vs. − 13.9%, <i>p</i> &lt; 0.001), and GLSepi (–10.6% vs. − 12.2%, <i>p</i> &lt; 0.001). The risk of death increased linearly with decreasing absolute GLS for all layers (<i>p</i> &lt; 0.0002). In multivariable Cox models adjusted for clinical and echocardiographic baseline characteristics, all layer-specific strain parameters remained significantly associated with mortality. However, only GLSepi remained significant after adjusting for European System for Cardiac Operative Risk Evaluation II (EuroSCORE II); (GLSepi: HR = 1.09 (1.00–1.18), <i>p</i> = 0.043, per 1% absolute decrease). For secondary outcomes (HF and HF/CVD), all strain parameters were associated with HF/CVD in fully adjusted models; however, no layer was independently associated with HF after multivariable analysis.</p> Conclusion <p>Layer-specific GLS is an independent prognosticator of all-cause mortality, HF, and HF/CVD. In multivariable models for mortality, GLSepi provided significant prognostic value after adjusting for EuroSCORE II.</p> Graphical abstract <p></p>

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Prognostic value of Layer-Specific global longitudinal strain in patients undergoing Coronary Artery Bypass Grafting

  • 期刊论文

  • 发表日期：

    2025年11月26日

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  • Filip Soeskov Davidovski,
  • Mats Christian Højbjerg Lassen,
  • Kristoffer Grundtvig Skaarup,
  • Mohammad Nizar Ramadan,
  • Caroline Espersen,
  • Flemming Javier Olsen,
  • Morten Sengeløv,
  • Søren Lindberg,
  • Thomas Fritz-Hansen,
  • Sune Pedersen,
  • Allan Iversen,
  • Søren Galatius,
  • Gunnar Gislason,
  • Rasmus Møgelvang,
  • Tor Biering-Sørensen

摘要

Purpose

To determine the prognostic value of layer-specific global longitudinal strain (GLS) after coronary artery bypass grafting (CABG).

Methods

This retrospective cohort study comprised 641 patients undergoing isolated CABG between 2006 and 2011. Layer-specific GLS was assessed by echocardiography using two-dimensional speckle tracking. Patients were followed through nation-wide registries for all-cause mortality, heart failure (HF), and the composite endpoint of HF or cardiovascular death (CVD) (HF/CVD).

Results

During follow-up (3.8 years [IQR: 2.7; 4.9]), 73 patients died, and 62 developed HF/CVD (HF: n = 30, CVD: n = 38). Patients who died had reduced GLS in all layers; GLSendo (–14.2% vs. − 16.3%, p < 0.001), whole wall GLS (–12.1% vs. − 13.9%, p < 0.001), and GLSepi (–10.6% vs. − 12.2%, p < 0.001). The risk of death increased linearly with decreasing absolute GLS for all layers (p < 0.0002). In multivariable Cox models adjusted for clinical and echocardiographic baseline characteristics, all layer-specific strain parameters remained significantly associated with mortality. However, only GLSepi remained significant after adjusting for European System for Cardiac Operative Risk Evaluation II (EuroSCORE II); (GLSepi: HR = 1.09 (1.00–1.18), p = 0.043, per 1% absolute decrease). For secondary outcomes (HF and HF/CVD), all strain parameters were associated with HF/CVD in fully adjusted models; however, no layer was independently associated with HF after multivariable analysis.

Conclusion

Layer-specific GLS is an independent prognosticator of all-cause mortality, HF, and HF/CVD. In multivariable models for mortality, GLSepi provided significant prognostic value after adjusting for EuroSCORE II.

Graphical abstract