Global Longitudinal Strain and Global Circumferential Strain on Echo Heart Failure Score as 60-days Readmission Predictor in Congestive Heart Failure Patients with Left Ventricle Systolic Dysfunction in Makassar City

Article History

Submited : July 23, 2021
Published : October 21, 2021

Introduction: The readmission rate due to heart failure increases every year in South Sulawesi. A Frequently used method for assessing readmission is an echocardiographic examination by measuring ejection fraction. However, recent studies show that the speckle tracking parameters are more sensitive to predict readmission of heart failure patients. In this study, we assess the role of Global Longitudinal Strain (GLS) and Global Circumferential Strain (GCS) parameters on the Echo Heart Failure Score (EHFS) as a 60-days readmission predictor in heart failure patients. Methods: We included 175 patients admitted through the inpatient installation of Integrated Heart Center Dr. Wahidin Sudirohusodo General Hospital. In addition, we reviewed up to 60 days after outpatient prospectively by collecting data through medical records. The correlation between echocardiographic parameters and readmissions was analyzed using the Spearman Rank Correlation. To determine each echocardiographic parameter's cut-off point, sensitivity, and specificity, we use Receiver Operating Characteristic (ROC) curve. Results:GLS and GCS are very sensitive and specific parameters in predicting 60-days readmission with an area under the curve (AUC) value > 0.7. This study shows that adding GLS and GCS parameters to the EHFS increases the predicted value (AUC 0.850 vs. 0.820) and sensitivity to 79%. Conclusion: GLS and GCS parameters additional on EHFS can help predict 60-days readmission of heart failure patients with sensitivity and specificity of 79% and 83%, respectively. The present study shows that with higher GLS and GCS scores on the EHFS, the risk of readmission in heart failure patients will increase.

References

  1. Ponikowski, P., Voors, A. A., Anker, S. D., et al. ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure. Rev Esp Cardiol (Engl Ed) 2016a, 69: p1167.
  2. Mcalister, F. A., Youngson, E., Bakal, J. A., Kaul, P., Ezekowitz, J. & Van Walraven, C. Impact of Physician Continuity on Death or Urgent Readmission after Discharge among Patients with Heart Failure. CMAJ, 2013, 185: p681-9.
  3. O'Connor, C. M. High Heart Failure Readmission Rates: Is It the Health System's Fault? JACC Heart Fail 2017, 5: p393.
  4. Yanai, H., Adachi, H. & Hakoshima, M. Understanding of Hypertension and Heart Failure in Patients with Type 2 Diabetes by Studying Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Plasma B-type Natriuretic Peptide Levels. J Clin Hypertens (Greenwich) 2018, 20: p411-12.
  5. Baysan,O., Ocakli,E.P., Saglam,Y., Altuner,T.K., Hospital,G. Advances in Echocardiography: Global Longitudinal Strain, Intra-Cardiac Multidirectional Flow Imaging and Automated 3D Volume Analysis. HVT J, 2018: 2.
  6. Mondello, S., Galerisi, M., Mele, D., et al. Speckle-Tracking Echocardiography: a New Technique for Assessing Myocardial Function. J Ultrasound Med 2011, 30: p71-8
  7. Prater, D., Vogel, J. 2014. Automated Cardiac Motion Quantification. Philips Health Care, accessed 25 February 2019, https://images.philips.com/is/content/PhilipsConsumer/Campaigns/HC20140401_DG/Documents/LR_452299111541_aCMQ_WP_FNL.pdf?elqTrackId=6a7a5a77c87440f7a436ae4e3f741539&elqaid=208&elqat=2
  8. Purwowiyoto,S.L., ’Aplikasi Klinis Ekokardiografi Dua Dimensi Speckle Tracking pada Pasien Gagal Jantung’,YARSI Med Journal 2017, 25(1): p52-67.
  9. Zhang, W., French, B., Khan, M.A., et al., Strain Improves Risk Prediction Beyond Ejection Fraction in Chronic Systolic Heart Failure. J Am Heart Assoc 2014, 3: p1-9.
  10. Buggey, J., Alenezi, F., Yoon, H.J., et al. Left Ventricular Global Longitudinal Strain in Patients with Heart Failure with Preserved Ejection Fraction: outcomes following an acute heart failure hospitalization. ESC 2017, 4: p432-39.
  11. Carluccio, E., Dini, F. L., Biagioli, P., et.al. The 'Echo Heart Failure Score': an Echocardiographic Risk Prediction Score of Mortality in Systolic Heart Failure. Eur J Heart Fail 2013, 15: p868-76.
  12. Park, J.J., Park, J.B., Park, J.H., Cho, G.Y. Global Longitudinal Strain to Predict Mortality in Patients with Acute Heart Failure. JACC Heart Fail 2018,18: p1947-57
  13. Romano, S., Judd, R.M., Kim, R.J., et al., Association of Feature- Tracking Cardiac Magnetic Resonance Imaging Left Ventricular Global Longitudinal Strain with All-Cause Mortality in Patients with Reduced Left Ventricular Ejection Fraction. Circ AHA 2017, 135: p2313-15
  14. Mignot, A., Donal, E., Zaroui, A., et al. Global Longitudinal Strain as a Major Predictor of Cardiac Events in Patients with Depressed Left Ventricular Function: A Multicenter Study. J Am Soc Echocardiogr 2010, 23(10): p1019-24.
Muzakkir, A. F., Amir, M., Kabo, P., Saleh, K., Bahar, B., Ghaznawie, A. F., Tandean, F. A., & Mappangara, I. (2021). Global Longitudinal Strain and Global Circumferential Strain on Echo Heart Failure Score as 60-days Readmission Predictor in Congestive Heart Failure Patients with Left Ventricle Systolic Dysfunction in Makassar City. Nusantara Medical Science Journal, 6(1), 18-32. https://doi.org/10.20956/nmsj.v6i1.14674

Downloads

Download data is not yet available.
Fulltext