Global Longitudinal Strain Is Associated with Mortality in Patients with Multiple Myeloma

Zhu Cui; Francesco Castagna; Waqas Hanif; Samuel J. Apple; Lili Zhang; James M. Tauras; Ira Braunschweig; Gurbakhash Kaur; Murali Janakiram; Yanhua Wang; Yanan Fang; Juan C. Diaz; Carolina Hoyos; Jorge Marin; Patricia A. Pellikka; Jorge E. Romero; Mario J. Garcia; Amit K. Verma; Nishi Shah; Leandro Slipczuk

doi:10.3390/jcm12072595

Global Longitudinal Strain Is Associated with Mortality in Patients with Multiple Myeloma

Zhu Cui, Francesco Castagna, Waqas Hanif, Samuel J. Apple, Lili Zhang, James M. Tauras, Ira Braunschweig, Gurbakhash Kaur, Murali Janakiram, Yanhua Wang, Yanan Fang, Juan C. Diaz, Carolina Hoyos, Jorge Marin, Patricia A. Pellikka, Jorge E. Romero, Mario J. Garcia, Amit K. Verma, Nishi Shah, Leandro Slipczuk

Cardiovascular Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Patients with multiple myeloma (MM) are at a high risk for developing cardiovascular complications. Global longitudinal strain (GLS) can detect early functional impairment before structural abnormalities develop. It remains unknown if reduced GLS is associated with reduced survival in patients with MM. We conducted a retrospective cohort analysis of patients diagnosed with MM between 1 January 2000 and 31 December 2017 at our institution. Patients with a 2D transthoracic echocardiogram completed within 1 year of MM diagnosis, left ventricular ejection fraction (LVEF) greater than 40%, and no history of myocardial infarction prior to MM diagnosis were included. GLS was measured using an artificial-intelligence-powered software (EchoGo Core), with reduced GLS defined as an absolute value of <18%. The primary outcome of interest was overall survival since myeloma diagnosis. Our cohort included 242 patients with a median follow up of 4.28 years. Fifty-two (21.5%) patients had reduced average GLS. Patients with reduced GLS were more likely to have an IVSd ≥ 1.2cm, E/E’ > 9.6, LVEF/GLS > 4.1, higher LV mass index, and low-voltage ECG. A Total of 126 (52.1%) deaths occurred during follow-up. Overall survival was lower among patients with reduced GLS (adjusted HR: 1.81, CI: 1.07–3.05).

Original language	English (US)
Article number	2595
Journal	Journal of Clinical Medicine
Volume	12
Issue number	7
DOIs	https://doi.org/10.3390/jcm12072595
State	Published - Apr 2023

Keywords

ECG
Echo
global longitudinal strain
multiple myeloma
survival

ASJC Scopus subject areas

General Medicine

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10.3390/jcm12072595

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Cui, Z., Castagna, F., Hanif, W., Apple, S. J., Zhang, L., Tauras, J. M., Braunschweig, I., Kaur, G., Janakiram, M., Wang, Y., Fang, Y., Diaz, J. C., Hoyos, C., Marin, J., Pellikka, P. A., Romero, J. E., Garcia, M. J., Verma, A. K., Shah, N., & Slipczuk, L. (2023). Global Longitudinal Strain Is Associated with Mortality in Patients with Multiple Myeloma. Journal of Clinical Medicine, 12(7), Article 2595. https://doi.org/10.3390/jcm12072595

Cui, Z, Castagna, F, Hanif, W, Apple, SJ, Zhang, L, Tauras, JM, Braunschweig, I, Kaur, G, Janakiram, M, Wang, Y, Fang, Y, Diaz, JC, Hoyos, C, Marin, J, Pellikka, PA, Romero, JE, Garcia, MJ, Verma, AK, Shah, N & Slipczuk, L 2023, 'Global Longitudinal Strain Is Associated with Mortality in Patients with Multiple Myeloma', Journal of Clinical Medicine, vol. 12, no. 7, 2595. https://doi.org/10.3390/jcm12072595

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title = "Global Longitudinal Strain Is Associated with Mortality in Patients with Multiple Myeloma",

abstract = "Patients with multiple myeloma (MM) are at a high risk for developing cardiovascular complications. Global longitudinal strain (GLS) can detect early functional impairment before structural abnormalities develop. It remains unknown if reduced GLS is associated with reduced survival in patients with MM. We conducted a retrospective cohort analysis of patients diagnosed with MM between 1 January 2000 and 31 December 2017 at our institution. Patients with a 2D transthoracic echocardiogram completed within 1 year of MM diagnosis, left ventricular ejection fraction (LVEF) greater than 40%, and no history of myocardial infarction prior to MM diagnosis were included. GLS was measured using an artificial-intelligence-powered software (EchoGo Core), with reduced GLS defined as an absolute value of <18%. The primary outcome of interest was overall survival since myeloma diagnosis. Our cohort included 242 patients with a median follow up of 4.28 years. Fifty-two (21.5%) patients had reduced average GLS. Patients with reduced GLS were more likely to have an IVSd ≥ 1.2cm, E/E{\textquoteright} > 9.6, LVEF/GLS > 4.1, higher LV mass index, and low-voltage ECG. A Total of 126 (52.1%) deaths occurred during follow-up. Overall survival was lower among patients with reduced GLS (adjusted HR: 1.81, CI: 1.07–3.05).",

keywords = "ECG, Echo, global longitudinal strain, multiple myeloma, survival",

author = "Zhu Cui and Francesco Castagna and Waqas Hanif and Apple, {Samuel J.} and Lili Zhang and Tauras, {James M.} and Ira Braunschweig and Gurbakhash Kaur and Murali Janakiram and Yanhua Wang and Yanan Fang and Diaz, {Juan C.} and Carolina Hoyos and Jorge Marin and Pellikka, {Patricia A.} and Romero, {Jorge E.} and Garcia, {Mario J.} and Verma, {Amit K.} and Nishi Shah and Leandro Slipczuk",

note = "Publisher Copyright: {\textcopyright} 2023 by the authors.",

year = "2023",

month = apr,

doi = "10.3390/jcm12072595",

language = "English (US)",

volume = "12",

journal = "Journal of Clinical Medicine",

issn = "2077-0383",

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T1 - Global Longitudinal Strain Is Associated with Mortality in Patients with Multiple Myeloma

AU - Cui, Zhu

AU - Castagna, Francesco

AU - Hanif, Waqas

AU - Apple, Samuel J.

AU - Zhang, Lili

AU - Tauras, James M.

AU - Braunschweig, Ira

AU - Kaur, Gurbakhash

AU - Janakiram, Murali

AU - Wang, Yanhua

AU - Fang, Yanan

AU - Diaz, Juan C.

AU - Hoyos, Carolina

AU - Marin, Jorge

AU - Pellikka, Patricia A.

AU - Romero, Jorge E.

AU - Garcia, Mario J.

AU - Verma, Amit K.

AU - Shah, Nishi

AU - Slipczuk, Leandro

PY - 2023/4

Y1 - 2023/4

N2 - Patients with multiple myeloma (MM) are at a high risk for developing cardiovascular complications. Global longitudinal strain (GLS) can detect early functional impairment before structural abnormalities develop. It remains unknown if reduced GLS is associated with reduced survival in patients with MM. We conducted a retrospective cohort analysis of patients diagnosed with MM between 1 January 2000 and 31 December 2017 at our institution. Patients with a 2D transthoracic echocardiogram completed within 1 year of MM diagnosis, left ventricular ejection fraction (LVEF) greater than 40%, and no history of myocardial infarction prior to MM diagnosis were included. GLS was measured using an artificial-intelligence-powered software (EchoGo Core), with reduced GLS defined as an absolute value of <18%. The primary outcome of interest was overall survival since myeloma diagnosis. Our cohort included 242 patients with a median follow up of 4.28 years. Fifty-two (21.5%) patients had reduced average GLS. Patients with reduced GLS were more likely to have an IVSd ≥ 1.2cm, E/E’ > 9.6, LVEF/GLS > 4.1, higher LV mass index, and low-voltage ECG. A Total of 126 (52.1%) deaths occurred during follow-up. Overall survival was lower among patients with reduced GLS (adjusted HR: 1.81, CI: 1.07–3.05).

AB - Patients with multiple myeloma (MM) are at a high risk for developing cardiovascular complications. Global longitudinal strain (GLS) can detect early functional impairment before structural abnormalities develop. It remains unknown if reduced GLS is associated with reduced survival in patients with MM. We conducted a retrospective cohort analysis of patients diagnosed with MM between 1 January 2000 and 31 December 2017 at our institution. Patients with a 2D transthoracic echocardiogram completed within 1 year of MM diagnosis, left ventricular ejection fraction (LVEF) greater than 40%, and no history of myocardial infarction prior to MM diagnosis were included. GLS was measured using an artificial-intelligence-powered software (EchoGo Core), with reduced GLS defined as an absolute value of <18%. The primary outcome of interest was overall survival since myeloma diagnosis. Our cohort included 242 patients with a median follow up of 4.28 years. Fifty-two (21.5%) patients had reduced average GLS. Patients with reduced GLS were more likely to have an IVSd ≥ 1.2cm, E/E’ > 9.6, LVEF/GLS > 4.1, higher LV mass index, and low-voltage ECG. A Total of 126 (52.1%) deaths occurred during follow-up. Overall survival was lower among patients with reduced GLS (adjusted HR: 1.81, CI: 1.07–3.05).

KW - ECG

KW - Echo

KW - global longitudinal strain

KW - multiple myeloma

KW - survival

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JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

IS - 7

M1 - 2595

ER -

Global Longitudinal Strain Is Associated with Mortality in Patients with Multiple Myeloma

Abstract

Keywords

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