Global longitudinal strain and outcome after endoscopic mitral valve repair

Kotrč, Martin; Bartúnek, Jozef; Benes, Jan; Beles, Monika; Vanderheyden, Marc; Casselman, Filip; Ondrúš, Tomáš; Mo, Yujing; Praet, Frank Van; Pěnička, Martin

doi:10.1002/ehf2.14001

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…LAS-r was a significant independent predictor of LA reverse remodeling. [ 55 ] Reduced LAS-r ≤24% showed worse survival at a median of 6.4 years, regardless of the symptomatic status before surgery. [ 56 ] During a median follow-up of 45 months after successful MV repair surgery, patients with high preoperative LAS-r ≥23.6% had better clinical outcomes regardless of LA volume index.…”

Section: Itral R Egurgitationmentioning

confidence: 99%

Potential Diagnostic and Prognostic Values of Left Atrial Strain in Valvular Heart Disease

Anwar

2024

Journal of Cardiovascular Echography

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There has been increasing evidence supporting the importance of left atrial (LA) functional analysis and measurement in various physiologic and pathologic cardiovascular conditions due to its high diagnostic and prognostic values. Assessment of LA strain (LAS) has emerged as an early marker of subclinical LA dysfunction. Using speckle-tracking echocardiography, LAS can be measured in all phases of LA function (reservoir, conduit, and booster pump). In valvular heart disease (VHD), surgical and nonsurgical interventions should be performed before irreversible left ventricular (LV) and/or LA myocardial dysfunction. The current guidelines recommended using LV strain as a parameter for early detection and timely intervention. Currently, many published data have shown the diagnostic and prognostic values of LAS in VHD, which is encouraging to integrate LAS during echo assessment. In this review, we aim to collect the current data about the clinical utility of LAS changes in risk stratification, predicting outcome, and guiding the time of intervention in VHD. The review summarized these data according to the type of valve pathologies.

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Section: Itral R Egurgitationmentioning

confidence: 99%

Potential Diagnostic and Prognostic Values of Left Atrial Strain in Valvular Heart Disease

Anwar

2024

Journal of Cardiovascular Echography

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Global longitudinal strain and outcome after endoscopic mitral valve repair

Kotrč

Bartúnek²,

Benes

et al. 2022

ESC Heart Failure

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Aims Identification of heart failure (HF) patients with secondary mitral regurgitation (SMR) that benefit from mitral valve (MV) repair remains challenging. We have focused on the role of left ventricular global longitudinal strain (LV-GLS) and reservoir left atrial longitudinal strain (LASr) for the prediction of long-term survival and reverse remodelling in patients with SMR undergoing endoscopic MV repair. Methods and resultsThe study population consisted of 110 patients (age 67 ± 11 years, 66% men) with symptomatic SMR undergoing isolated MV repair using a minimally invasive surgical approach. Speckle tracking-derived LV-GLS and LASr were assessed in apical views using vendor-independent software. Over a median of 7.7 years (IQRs 2.9-11.2), 64 patients (58%) died. Significant reverse LV (↓ LVESVI >10 mL/m 2 ), LA (↓ LAVI >10 mL/m 2 ) remodelling or both were observed in 43 (39%), 37 (34%) and 19 (17%) patients, respectively. LV-GLS (HR 0.68, 95% CI 0.58-0.79, P < 0.001) and LASr (HR 0.93, 95% CI 0.88-0.97, P < 0.01) but not LV ejection fraction (LVEF) and LA volume index (LAVi) emerged as independent predictors of all-cause mortality in Cox regression analysis. LV-GLS was the only independent predictor of LV reverse remodelling (OR 1.24, 95% CI 1.05-1.43, P < 0.001) whereas LAVi and LASr were both independent predictors of LA reverse remodelling (both P < 0.05). In patients with atrial fibrillation at baseline, only LASr was an independent predictor (P < 0.05) of LA reverse remodelling. Conclusions In patients with SMR undergoing endoscopic MV repair, LV-GLS and LASr are independently associated with long-term survival and reverse remodelling and may be helpful in selecting SMR patients who may benefit from this procedure.

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Utility of Global Longitudinal Strain in Mitral Regurgitation: A Systematic Review

Krupa,

Lall

2023

Journal of the Indian Academy of Echocardiography &Amp; Cardiovascular Imaging

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Background: The assessment of myocardial function is important in both primary and secondary mitral regurgitation (MR), to determine the timing of interventions and to predict outcomes. Ejection fraction is relied on for clinical decisions, even though, it is well understood that it does not reflect myocardial function. Global longitudinal strain (GLS) is a promising parameter that correlates well with outcomes postinterventions. In this review, we aimed to determine the utility of GLS in both primary and secondary MR in predicting clinical outcomes. We also aimed to determine the GLS cutoff at which clinical decisions can be made. Methods: We conducted a systematic review of the literature regarding the use of GLS as a predictor of left ventricular (LV) function. We searched PubMed and Embase for relevant articles and identified 141 articles after removing duplicates. We screened titles and abstracts to identify 28 relevant articles from which data were extracted. Results: In 16 of the 28 studies, patients had primary MR mostly of degenerative etiology and the LV GLS cutoff for events ranged from −17.2% to −21%. In 10 studies, patients with secondary MR were included, and a cutoff ranging from −7%− to −9% was most often reported except for one study that reported-16.3%, as it included patients with atrial functional MR. Conclusion: GLS assesses LV dysfunction and is a good predictor of clinical and echocardiographic outcomes postinterventions. Values lower than the cutoff value of −17.2% to −21% in primary MR and −7% to −9% in secondary MR are associated with poorer outcomes. These findings suggest that the use of GLS as a routine assessment in patients with significant MR may be appropriate for both clinical decision-making and prognostication.

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Global longitudinal strain and outcome after endoscopic mitral valve repair

Cited by 3 publications

References 38 publications

Potential Diagnostic and Prognostic Values of Left Atrial Strain in Valvular Heart Disease

Potential Diagnostic and Prognostic Values of Left Atrial Strain in Valvular Heart Disease

Global longitudinal strain and outcome after endoscopic mitral valve repair

Utility of Global Longitudinal Strain in Mitral Regurgitation: A Systematic Review

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