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.