Determinants of Left Ventricular Global Longitudinal Strain in a Ghanaian Cohort

Background Cardiovascular disease, particularly heart failure, poses a significant global health burden, especially in low- to middle-income regions like Africa, where resources are limited. Heart failure is often related to various risk factors. Modern imaging techniques, like speckle-tracking echocardiography, enhance the detection of subclinical cardiac dysfunction. Early identification and management of these risk factors could prevent progression to HF, emphasizing the need for routine, patient-level interventions. Objectives The specific objective was to find the correlation between the clinical risk factors and conventional echocardiographic/Doppler markers of diastolic and systolic dysfunction with left ventricular global longitudinal strain. Methods This was a single-center, retrospective, analytical study of consecutive patients who underwent echocardiograms, in which we compared demographic, clinical, and 2-dimensional echocardiographic variables of diastolic and systolic function with left ventricular global longitudinal strain using univariate linear regression analysis. This study received ethical clearance with Approval No. HTH-REC(38) FC_2024 from the Ho Teaching Hospital Research and Ethics Committee (HTH-REC). Results The average patient age was 57 years. About half were female patients; most were overweight or obese, and had blood pressures in the hypertensive range. Most had normal two-dimensional echocardiographic parameters, but with borderline or abnormal left ventricular global longitudinal strain. Body mass index, systolic and diastolic blood pressure, left ventricular mass index, e', E/e', and left ventricular ejection fraction correlated significantly with left ventricular global longitudinal strain. Conclusion The burden of traditional risk factors for heart failure and structural/functional cardiac abnormalities is high among patients who presented to a community cardiologic clinic. Body mass index, systolic blood pressure, diastolic blood pressure, e', E/e', and left ventricular ejection fraction (LVEF) independently correlated with left ventricular global longitudinal strain (LVGLS), a valuable parameter in evaluating left ventricular (LV) systolic function, even when LVEF is normal, underscoring its role in risk stratification and early intervention for patients at risk of heart failure.