Abstract 15120: Effect of Prolonged Left Ventricular Global Longitudinal Strain Reduction After Exercise on the Development of Cardiovascular Events

Introduction: Recently, it has also been reported that patients with ischemic heart disease have prolonged left ventricular (LV) GLS reduction after exercise.

Hypothesis: To investigate the influence of prolonged LV GLS reduction after exercise on the development of cardiovascular events.

Methods: One hundred thirty-three consecutive patients with at least one of the following coronary risk factors: hypertension, hyperlipidemia, or diabetes mellitus underwent echocardiography (ARTIDA; Canon medical, Japan) before and 30 minutes after Master double exercise and LV GLS was measured offline (Vitria; Canon medical, Japan). Patients with obvious LV wall motion abnormalities, significant valvular heart disease, or atrial fibrillation were excluded. The incidence of cardiovascular events was determined from the patients' medical records. Patients were divided into three groups based on the occurrence of cardiovascular events up to 6 months after the examination: non-events group, minor cardiovascular event group (chest pain, palpitations, other additional tests), and major cardiovascular event group (coronary revascularization, cardiac hospitalization). The LV GLSs before and 30 minutes after exercise were compared in each patient group.

Results: Mean age was 63±11.5years (female: 25%). Patients had hypertension (53%), hyperlipidemia (47%), and diabetes (65%). Of the 133 eligible patients, non-event group (n=68), minor cardiovascular event group (n=50), and major cardiovascular event group (n=15). LV GLS before exercise was not significantly different between the groups, however LV GLS at 30 minutes after exercise were significantly lower in the cardiovascular event groups and were proportional to the severity of the event. (Figure)

Conclusions: The prolonged reduction in LV GLS after exercise could be a useful predictive index for the development of cardiovascular events.