Clinical Outcomes
Two of the studies included in this systematic review assessed primary and secondary longitudinal cardiovascular events in these populations(13, 14). In patients with myocarditis, every 1% decline in longitudinal strain increased hazard ratios by 1.26 (95% CI: 1.10–1.47) for primary cardiovascular MACE events(13). Similarly, in patients with ICI myocarditis, after adjustment for LVEF, each 1% reduction in GLS was associated with a 1.5-fold increase in cardiovascular MACE among patients with impaired systolic function (HR: 1.5; 95% CI: 1.2-1.8) and a 4.4-fold increase with a preserved systolic function (HR: 4.4; 95% CI: 2.4-7.8) (14). These results highlight the value of LV-GLS in the diagnosis and prognostication of patients with acute inflammatory and ICI myocarditis, independent of two-dimensional LVEF.