Abstract 16529: Usefulness of Left Ventricle Global Longitudinal Strain to Predict Cardiovascular Outcomes in Patients With Chagas Cardiomyopathy

Introduction: Chagas cardiomyopathy (CC) is associated with a high incidence of cardiovascular events. Global longitudinal strain (GLS) has been shown to be useful in predicting adverse cardiovascular outcomes in various patient populations. However, its prognostic value in CC is unknown. Hypothesis: Left ventricle global longitudinal strain (GLS), a more sensitive marker of myocardial damage, can predict outcomes in CC. Methods: This study was a prospective analysis of CC subjects with echocardiographic examinations from 2011-2014. GLS was defined as the average of three apical peak longitudinal strain measurements of the LV using a vendor-independent software. Lower GLS reflects better systolic function. GLS groups were defined according to tertiles: (1) GLS ≤ -18.9%, (2) GLS > -18.9% and Results: GLS was obtained in 85 subjects, 52% were males and mean age was 55±14 years. There were 7.3% losses of follow-up and the mean LVEF was 52±14 %. . After a follow up period of 28±19 months, 39 subjects reached the composite outcome. Hospitalization was the most frequent outcome (n=15), followed by death (n=12), decrease of LVEF (n=8), new heart failure (n=3), stroke (n=3) and STV (n=1). The GLS group 3 was associated with worse prognosis when compared with the GLS groups 1 and 2 (logrank-p-value = 0.001 for both comparisons), figure 1 .On multivariate Cox proportional hazard model, adjusting for age, gender and LVEF, GLS was an independent predictor of outcomes with HR 2.7 per 5% absolute change in GLS (CI=1.31-5.54;p=0.007). Conclusion: Left ventricle GLS is an independent predictor of cardiovascular outcomes in patients with Chagas cardiomyopathy. GLS may be an important tool to Chagas disease risk stratification, independent of ejection fraction.