{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:36:20Z","timestamp":1787740580572,"version":"build-2784847793"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,10,11]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In obstructive hypertrophic cardiomyopathy patients with preserved left ventricular (LV) ejection fraction, we sought to determine whether\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              global longitudinal strain (\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content>\n              ) provided incremental prognostic utility.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We studied 1019 patients with documented hypertrophic cardiomyopathy (mean age, 50\u00b112\u00a0years; 63% men) evaluated at our center between 2001 and 2011. We excluded age &lt;18\u00a0years, maximal\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              outflow tract gradient &lt;30\u00a0mm\u00a0Hg, bundle branch block or atrial fibrillation, past pacemaker\/cardiac surgery, including myectomy\/alcohol ablation, and obstructive coronary artery disease. Average resting\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content>\n              was measured offline on 2\u2010, 3\u2010, 4\u2010chamber views using Velocity Vector Imaging (Siemens, Malvern,\n              <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\n              ). Outcome was a composite of cardiac death and appropriate internal defibrillator (implantable cardioverter defibrillator) discharge. Maximal\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              thickness, LV ejection fraction, indexed left atrial dimension, rest and maximal\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              outflow tract gradient, and\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content>\n              were 2.0\u00b10.2\u00a0cm, 62\u00b14%, 2.2\u00b14\u00a0cm\/m\n              <jats:sup>2<\/jats:sup>\n              , 52\u00b142\u00a0mm\u00a0Hg, 103\u00b136\u00a0mm\u00a0Hg, and \u221213.6\u00b14%. During 9.4\u00b13\u00a0years of follow\u2010up, 668 (66%), 166 (16%), and 122 (20%), respectively, had myectomy, atrial fibrillation, and implantable cardioverter defibrillator implantation, whereas 69 (7%) had composite events (62 cardiac deaths). Multivariable competing risk regression analysis revealed that higher age (subhazard ratio, 1.04 [1.02\u20131.07]),\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              during follow\u2010up (subhazard ratio, 1.39 [1.11\u20131.69]), and worsening\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content>\n              (subhazard ratio, 1.11 [1.05\u20131.22]) were associated with worse outcomes, whereas myectomy (subhazard ratio, 0.44 [0.25\u20130.72]) was associated with improved outcomes (all\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). Sixty\u2010one percent of events occurred in patients with\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content>\n              worse than median (\u221213.7%).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In obstructive hypertrophic cardiomyopathy patients with preserved LV ejection fraction, abnormal\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content>\n              was independently associated with higher events, whereas myectomy was associated with improved outcomes.\n            <\/jats:p>\n          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