Utility of Global Longitudinal Strain to Predict Post-Operative Outcomes in Non-Cardiac Surgeries

Abstract

Background: Pre-operative echocardiography is performed in select groups of patients for cardiac risk stratification. Many parameters, including Left Ventricular Ejection Fraction (LVEF), are assessed during echocardiography. While many studies have cited association between low LVEF and poor operative outcomes, patients with preserved LVEF might have subtle LV dysfunction that may result in adverse outcome. Studies have described the routine use of global longitudinal strain (GLS) as an alternative measure of ventricular function that can detect subtle LV dysfunction. The aim of this study is to determine the value of GLS in predicting post-operative outcomes in non-cardiac surgeries. Methods: This was a retrospective study of patients who had normal LVEF, had undergone subsequent non-cardiac surgery, and had post-operative troponins measured. Outcomes for post-operative myocardial injury, as well as hospital re-admissions and mortality up to 1-year post-surgery were collected. Post-op myocardial injury was defined as a peak Troponin T value of > 0.030 ng/dL or a > 20% increment from baseline. Results: A total of 42 patients were included. 61.9% (n = 26) were males and mean age was 72.3 years. Mortality at 1 year was 14.3% (n = 6) and 28.6% (n = 12) were deemed to have post-operative myocardial injury. 1-year mortality was associated with lower GLS (-18.95% vs. -23.75%, p = 0.001). However, GLS was not associated with post-operative myocardial injury and hospital readmissions. Conclusion: Although GLS values were decreased in non-survivors, our study did not demonstrate the utility of GLS in predicting post-operative events. BRief RePoRT