@article{102628,
  keywords = {Echocardiography, Chagas' disease, Deformation, Cardiomyopathies, cardiac ventricles, Heart Failure},
  author = {Romano MMD and Moreira HT and Alenezi F and Kisslo J and Lombo Lievano B and Schmidt A and Maciel BC and Marin-Neto JA and Velazquez EJ},
  editor = {Bowman N},
  title = {Global longitudinal strain as a predictor of outcomes in chronic Chagas´ cardiomyopathy},
  abstract = {<p><strong>Introduction</strong></p>

<p>Chronic Chagas cardiomyopathy (CCC) is associated with a high incidence of cardiovascular events. Global longitudinal strain (GLS) is useful in predicting adverse cardiovascular outcomes in several cardiomyopathies. However, its prognostic value in CCC is not well established.</p>

<p><strong>Methods</strong></p>

<p>This study was a retrospective echocardiography analysis with prospective follow-up of CCC subjects. GLS was defined as the average of three apical peak longitudinal strain measurements of the LV using vendor-independent software. GLS groups were defined according to tertiles: (1) GLS ≤ -18.4%, (2) GLS &gt; -18.4% and &lt;-13.8%, and (3) GLS ≥ -13.8%. The primary outcome was a composite of death, hospitalization, sustained ventricular tachycardia (SVT), new heart failure, any systemic embolism, hospitalization, reverted cardiac arrest and cardiac heart transplantation.</p>

<p><strong>Results</strong></p>

<p>GLS was obtained in 77 subjects, 50.6% were males and the mean age was 56 ± 15 years. There were 6.49% losses of follow-up and the mean LVEF was 51 ± 14%. After a follow-up period of 35 ± 19 months (2.9 y), 33 subjects reached the composite outcome. Death and hospitalization were the most frequent outcomes (n = 9), followed by new heart failure (n = 6), embolism (n = 6), and SVT (n = 3). The GLS ≥ -13.8% was associated with a worse prognosis when compared with the other tertile GLS groups (log rank-p-value = 0.001 for both comparisons). On the multivariate Cox proportional hazard model, adjusting for age, gender, and LVEF, GLS was an independent predictor of outcomes with an HR of 1.20 (CI = 1.05-1.38;p = 0.008).</p>

<p><strong>Conclusion</strong></p>

<p>Left ventricle GLS is an independent predictor of cardiovascular outcomes in patients with CCC. GLS may be an important tool for Chagas disease risk stratification, independent of LVEF.</p>
},
  year = {2025},
  journal = {PLOS Neglected Tropical Diseases},
  volume = {19},
  pages = {1-11},
  publisher = {Public Library of Science (PLoS)},
  issn = {1935-2735},
  url = {https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0012941&type=printable},
  doi = {10.1371/journal.pntd.0012941},
  language = {ENG},
}