Study population
Long-term follow up was available in 525 patients (87% of the 605 patients included in the final analysis of 2DSPER, 99% of the 529 patients from the 6 centers with available long-term follow-up). A histogram of GLS values derived from the baseline echocardiogram in the 525 patients with available long-term follow-up is presented in Figure 1. Median GLS was -18.7%. Patients were divided into “better GLS” group (GLS ≤ -18.7%, n=264) and “worse GLS” group (GLS > -18.7%, n=261). GLS was abnormal (> -17% according to current guidelines) in 120/525 patients (23%).24Patient characteristics are summarized in Table 1. Patients with worse GLS were more likely to be men. There was no difference in coronary risk factors, except for smoking which was more prevalent in patients with worse GLS. Patients with worse GLS had a higher body mass index, and higher creatinine and hemoglobin levels. There was no difference in medical treatment between groups
Echocardiographic findings are summarized in Table 2. Patients with worse GLS were: less likely to have high 2D image quality, more likely to have lower LVEF and wall motion abnormality and more likely to have thicker LV walls. Although they had more impaired early LV relaxation, there was no difference in their E/e’ ratio.
Data from initial ED visit and hospitalization is presented in Table 3. Patients with worse GLS were more likely to be admitted to the hospital and undergo invasive coronary angiography, and less likely to undergo coronary computed tomography angiography. They were more likely to be diagnosed with ACS, mostly unstable angina pectoris, and undergo revascularization.