GLS -10% as a predictor for LV reverse remodeling in SR
GLS -10% as cut-off for elevated VT risk in dil. CMP
GLS & mechanical dispersion as markers for ventricular arrhythmia (cut-off dispersion >70ms)
Ischemic heart disease ➜ Dispersion >70ms ➜ VT risk severely elevated with 16%/year; <70ms and dilatative CMP lowest risk with 3%/year
GLS measurement better than EF for risk stratification, Dispersion as EF-independent risk parameter
Dil. CMP with a GLS <-10% & prolonged dispersion
Dil. CMP with a GLS <-10% & prolonged dispersion
Jung et al., Journal of Cardiovascular Imaging, 2020 / Melichova et al., int. Journal of CV imaging, 2021 / Haugaa et al., JASE 2012
Peripartum CMP & Strain during pregnancy
Preeclampsia, HTN, African-American descent, >30a are risk factors; EF <45%; last month of pregnancy (mostly the last week before delivery) or the following weeks after birth (mostly 1st week, up to 6 months)
EF leads to late diagnosis, EF <30% only 1/3 normalizes EF in the follow-up; >30% EF, 2/3 of patients normalize EF
GLS drops in the 3rd trimester (volume overload) from -19% (1st and 2nd Trimester) to -17,6% with a normalisation postpartum
-18% as a cut-off in pregnant women >35a as a marker for an increase in „adverse maternal outcomes“ in the 2nd Trimester
LASr drops until the 3rd Trimester (40% in the 1st, 37% in the 2nd & 33% in the 3rd Trimester) and recovers postpartum. LASct is -17% in the 1st, -15% in the 2nd to -13% in the 3rd Trimester & recovers postpartum
Peripartum CMP recurrence cut-off -16% (with GLS -12% close to 100% probability for recurrence)
Peripartum CMP with HFrEF & severely reduced GLS
Normal LA-Strain & normal LVEF in pregnancy (2nd Trimester)
Peripartum CMP with HFrEF & severely reduced GLS
Normal LA-Strain & normal LVEF in pregnancy (2nd Trimester)
Savu et al., 2012 / Sonaglioni et al., 2021 / Tasar et al., 2019
Heart transplant rejection
Acute rejection (Antibody-mediated (AMR) & cellular mediated (ACR)) with a reduction in GLS
GLS reduction cut-off -15,5% in AMR 3 months before clinical event
AMR — acute (rejection) and in the follow-up, gradual reduction in GLS
ACR — reduction in GLS in acute rejection, improvement in the follow-up
GLS reduction as an early marker (before EF is reduced)
FWS cut-off for > Grad 1 rejection -17%
Myocardial wall thickening of the LV, normal EF
Diffuse reduction of Strain with a reduced GLS -14,2% — transplant rejection
Myocardial wall thickening of the LV, normal EF
Diffuse reduction of Strain with a reduced GLS -14,2% — transplant rejection
Agnieszka et al., European Heart Journal - Cardiovascular Imaging, November 2022
