ObjectiveTo assess the predictive value of peak global longitudinal strain (e) and e rate by speckle tracking to predict outcome in heart failure (HF) patients.MethodsThe study included 112 consecutive patients admitted for HF (64±13 years, 81% male, 52% ischemia) with reduced left ventricular ejection fraction (LVEF<50%, mean =31±10%, range 10-49]. Longitudinal global-ɛ and ɛ rate by speckle tracking were curves computed from apical views and compared to the occurrence of major cardiac events (death, heart transplantation, and recurrent HF).ResultsOn the whole, peak systolic longitudinal global-ɛ and ɛ rate averaged -8± 3% [range -3 to -18] and -0.34±0.20s-1 [range -1.6 to -0.1], respectively. During the follow up period (208±149 days), major cardiac adverse events occurred in 40 (36%) patients (11 death, 23 recurrent HF and 4 heart transplantation). Univariable analysis using Cox model shown that global-ɛ, ɛ rate, LVEF, tricuspid annular plane systolic excursion, NYHA class and BNP level were associated with cardiac adverse event. However, only global-ɛ (OR1.2, p=0.025) and BNP level (OR1.3, p=0.024) were predictive of outcome by multivariable analysis.ConclusionIn patients admitted for heart failure with impaired LVEF, peak global strain by speckle tracking appears to be the only echocardiography predictor of adverse outcome.