Global Longitudinal Strain Predicts Survival and Left Ventricular Function After Mitral Valve Surgery: A Meta-analysis

Canessa, Martín; Thamman, Ritu; Américo, Carlos; Soca, Gerardo; Dayan, Víctor

doi:10.1053/j.semtcvs.2020.09.024

Cited by 16 publications

(5 citation statements)

References 25 publications

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“…GLS mainly mirrors the contractility of subendocardial longitudinal fibers that often display impaired function in the early phase of myocardial injury, when LV ejection fraction (LVEF) can still be maintained 7 . LV GLS provides incremental value beyond LVEF in the prediction of adverse events in patients with chronic heart failure 8,9 , ischemic heart disease 10 , myocarditis 11 , valvular heart disease [12][13][14][15] , and several other cardiac diseases 4,[16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

Reproducibility of 4D cardiac computed tomography feature tracking myocardial strain and comparison against speckle-tracking echocardiography in patients with severe aortic stenosis

Bernhard

Grogg

Zurkirchen

et al. 2022

Journal of Cardiovascular Computed Tomography

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Section: Introductionmentioning

confidence: 99%

Reproducibility of 4D cardiac computed tomography feature tracking myocardial strain and comparison against speckle-tracking echocardiography in patients with severe aortic stenosis

Bernhard

Grogg

Zurkirchen

et al. 2022

Journal of Cardiovascular Computed Tomography

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“…While in the current study regression analysis for prediction of LVEF <50% after mitral valve surgery found the LVESD ≥40 mm and LVGLS < −19% were the better predictors with OR = 6.6 (95%CI 1.97–23.64) and 21.8 (95%CI 6.61–82.41) respectively. A meta-analysis from 8 studies with severe MR and preserved left ventricular ejection fraction has shown that reduced LV GLS before surgery was a predictor of worse post-operative survival and LVEF with HR = 1.13, 95% CI 1.02–1.26 [ 16 ]. While the study published by Tomasz et al [ 8 ] reported similar values of LVESD ≥40 mm and LVGLS > −19.9% were the better predictors of LVEF <50% after surgery with OR = 6.71 (1.91–23.52) and 23.16 (95%CI 6.53–82.10) respectively.…”

Section: Discussionmentioning

confidence: 75%

Role of speckle tracking echocardiography to predict LV dysfunction post mitral valve replacement surgery for severe mitral regurgitation

Shanishwara¹,

Vyas²,

Joshi³

et al. 2022

Journal of the Saudi Heart Association

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Background Despite improvement in the surgical procedure and strictly following the guidelines for mitral valve replacement (MVR), left ventricular dysfunction still occurs. Novel echocardiographic indices can predict development of LV (left ventricle) dysfunction post MVR. LV-GLS (global longitudinal strain) derived from speckle tracking echocardiography, has been proposed as a novel measure to better depict latent LV dysfunction. Methods A total of 100 patients with severe MR (mitral regurgitation) planned for MVR were included. Speckle tracking echocardiography was performed at baseline and at follow up post MVR. ROC (Receiver operating characteristics) curve was plotted to derive the cutoff value of LV-GLS for prediction of LV dysfunction post MVR. Univariate and multi variate regression was analyzed to predict the independent predictors of LV dysfunction after MVR. Results LV-GLS was decreased from baseline data (−19.9 vs. −17.7) in patients with LVEF <50% after MVR compared to patients with LVEF≥ 50%. Baseline value of LVESD (35.36 mm vs. 28.23 mm) and LVEDD (49.33 mm vs. 45.10 mm) were significantly higher in patients with LVEF<50% compared to LVEF ≥50% at 3 months follow up. A cutoff value of GLS −19% with sensitivity of 80.3% and specificity of 75.7% was associated in patients with LV dysfunction after MVR. In multivariate regression model GLS < −19% (OR = 21.8, CI:6.61–82.4, P=<0.001) was an independent predictor of LV dysfunction post MVR. Conclusion A GLS value of less than −19% was demonstrated as an independent predictor of short term LV dysfunction after mitral valve surgery, LVESD ≥40 mm was also verified additional parameter to predict the LV dysfunction post MVR.

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“…LV GLS allows early screening and better disease severity classification, even before left ventricular ejection fraction (LVEF) alteration. Reduced LV GLS in patients with preserved LVEF was associated with a worse outcome after mitral valve surgery and lower post-operative LVEF [ 70 ]. LV GLS is a more sensitive tool in evaluating myocardial damage and fibrosis than LVEF, which can be overestimated in mitral regurgitation.…”

Section: Echocardiographic Assessment: the General Principlementioning

confidence: 99%

Insight from International Guidelines: do We Have Satisfactory Recommendations for Secondary Mitral Regurgitation?

Nappi¹,

Singh²,

Fiore³

et al. 2022

Rev. Cardiovasc. Med.

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Both the European Society of Cardiology (ESC) and the American College of Cardiology (ACC/AHA) have recently released guidelines on the management of patients with secondary mitral regurgitation. This includes defining, classifying, and assessing the severity of secondary mitral regurgitation. These guidelines are also the first to incorporate the use of transcatheter edge-to-edge repair in decisionmaking based on recent studies. The review highlights the strengths and shortcomings of these studies and the applicability and generalisability of these results to assist in decision-making for the heart time. It also emphasises the importance of shared decision-making via the heart team. Echocardiography plays an important role in the assessment of these patients although these may be specifically for primary mitral insufficiency. The optimal guideline-directed medical therapy should be the first line of treatment followed by mechanical intervention. The choice of intervention is best directed by a specialist multidisciplinary team. Concomitant revascularization should be performed in a subgroup of patients with severe secondary mitral regurgitation given the role of adverse LV remodelling in propagation of the dynamic secondary MR. The guidelines need further confirmation from high-quality studies in the near future to decision-making towards either TEER, mitral valve replacement, or mitral valve repair with or without a subvalvular procedure.

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Global Longitudinal Strain Predicts Survival and Left Ventricular Function After Mitral Valve Surgery: A Meta-analysis

Cited by 16 publications

References 25 publications

Reproducibility of 4D cardiac computed tomography feature tracking myocardial strain and comparison against speckle-tracking echocardiography in patients with severe aortic stenosis

Reproducibility of 4D cardiac computed tomography feature tracking myocardial strain and comparison against speckle-tracking echocardiography in patients with severe aortic stenosis

Role of speckle tracking echocardiography to predict LV dysfunction post mitral valve replacement surgery for severe mitral regurgitation

Insight from International Guidelines: do We Have Satisfactory Recommendations for Secondary Mitral Regurgitation?

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