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We aimed to examine the longitudinal association between MS and MACEs in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical records from 336 patients with CSF (January 2019 to June 2022) were analyzed retrospectively. All patients underwent comprehensive echocardiography with MS quantified via speckle tracking echocardiography (STE), including left ventricular global longitudinal strain (LVGLS) and circumferential strain (LVGCS). MACEs were defined as the primary endpoint. Multivariable Cox regression analysis was performed to evaluate the association between MS and MACEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a median follow-up of 19 months (range: 6\u201351 months), MACEs occurred in 37.8% (127\/336). LVGCS was independently associated with MACEs (HR\u2009=\u20091.794, 95% CI 1.307\u20132.462,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) after adjusting for conventional risk factors and may provide incremental prognostic value beyond conventional risk factors (C statistics increased from 0.790 to 0.885; IDI\u2009=\u20090.172,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001; NRI\u2009=\u20090.790,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LVGCS was independently associated with MACEs in CSF patients. Adding LVGCS to conventional risk factors may provide incremental prognostic information, suggesting its potential utility for improving risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12880-026-02241-2","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T10:07:26Z","timestamp":1771668446000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incremental prognostic value of myocardial strain in patients with coronary slow flow"],"prefix":"10.1186","volume":"26","author":[{"given":"Binyu","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peixuan","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhui","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weizong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"issue":"1","key":"2241_CR1","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/0002-8703(72)90307-9","volume":"84","author":"AA Tambe","year":"1972","unstructured":"Tambe AA, Demany MA, Zimmerman HA, Mascarenhas E. 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Owing to the retrospective nature of the study, the need for informed consent from all subjects and\/or their legal guardians was waived by the Ethics Committee. To ensure data confidentiality, all personal identifiers (e.g., name, medical record number, contact information) were anonymized before data analysis, and access to de-identified data was restricted to the research team only. The study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki, as reflected in a priori approval by the institution\u2019s human research committee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"162"}}