ABC | Volume 113, Nº2, August 2019

Original Article Maia et al Global Longitudinal Strain in Functional Capacity Arq Bras Cardiol. 2019; 113(2):188-194 Figure 2 – ROC curve for evaluating the ability of the global longitudinal strain index (GLS) in predicting VO 2 < 14 mL/kg/min and VE/VCO 2 slope > 35. Sensitivity of 75% and specificity of 83% for a GLS cut-off of –5.7%, p = 0.03. 1,0 1,0 0,8 0,8 0,6 0,6 0,4 0,4 0,2 0,2 0,0 0,0 Sensitivity ROC curve Specificity was -9.5%. Our study correlated the GLS value with CPET parameters and suggested a cut-off point of -5.7% for GLS value, with sensitivity of 75% and specificity of 83% in predicting CPET heart transplantation’s criteria. Study limitations Considering the small number of patients included in this study, our findings that the GLS showed a strong correlation with the CPET data and have been able to identify the patients who had ergospirometric criteria of worse prognosis, need to be proven through a study with a larger number of patients and of long-term monitoring, and thus determine the real power of GLS in the prognostic assessment and therapeutic setting in systolic HF. Conclusion In systolic HF patients, the GLS showed significant association with the main parameters of CPET and was able to classify patients with low functional capacity. Thus, GLS may be a more accurate parameter than LVEF in stratifying systolic HF patients. Moreover, it may play a role in helping to evaluate patients in the end stage of HF. Author contributions Conception and design of the research: Brandão SCS, Brandão DC, Leite J, Martins SM, Andrade AD; Acquisition of data: Maia RJC, Brandão DC, Leite J, Pinheiro F, Araújo BTS, Aguiar MIR, Martins SM; Analysis and interpretation of the data: Brandão SCS, Brandão DC, Leite J, Parente GB, Pinheiro F, Araújo BTS, Aguiar MIR, Andrade AD; Statistical analysis: Brandão SCS, Parente GB; Writing of the manuscript: Maia RJC, Brandão SCS, Leite J; Critical revision of the manuscript for intellectual content: Brandão SCS, Brandão DC, Andrade AD. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by FACEPE APQ-0154-4.08/15; FACEPE IBPG-0450-4.08/17; National Council for Scientific and Technological Development (CNPq) 432865/2016-0 and Coordination for the Improvement of Higher Education Personnel (CAPES). Study Association This article is part of the thesis of master submitted by Rafael José Coelho Maia, fromUniversidade Federal de Pernambuco. Ethics approval and consent to participate This study was approved by the Ethics Committee of the Universidade Federal de Pernambuco under the protocol number 38572614.1.000.5208. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 192