Myocardial Strain in Prediction of Outcomes After Surgery for Severe Mitral Regurgitation

Kim, Hyue Mee; Cho, Goo Yeong; Hwang, Ingyu; Choi, Hyeong In; Park, Jun Bean; Kim, Yong Jin

doi:10.1016/j.jcmg.2018.03.016

Cited by 110 publications

(71 citation statements)

References 29 publications

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“…These ndings were in line with our previous report [21]. GLS is usually obtained from 2D-STI technology, which quantitatively measures the mechanical parameters for LV function [22,23]. GLS is considered to be a better indicator than EF and is widely used in clinics to assess LV function [24].…”

Section: Discussionsupporting

confidence: 89%

Value of quantitative analysis of left ventricular systolic function in patients on maintenance hemodialysis based on myocardial work technique

Liu

Feng²,

Song

et al. 2020

Preprint

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Background: To detect the left ventricular (LV) systolic function in maintenance hemodialysis (MHD) patients by using myocardial work (MW) technique. And investigated the clinical value of the MW technique for the quantitative analysis of left ventricular (LV) systolic function in MHD patients with left ventricular hypertrophy (LVH).Methods: A total of 58 MHD patients and 29 normal subjects were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n=32) and the LVH group (n=26) according to the LV myocardial index (LVMI). MW was used to generated the LV global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE. GLS and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) in the LVH group were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD patients with LVH.Results: The LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW in the LVH group. Receiver operating characteristic curve (ROC) analysis revealed that GWE, GWW, GWI, and GCW had appreciable area under the curve (AUC), sensitivity, and specificity for evaluating LV function in LVH patients. Conclusion: MW parameters can be effectively used to evaluate the LV systolic function in MHD patients with or without LVH.

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Section: Discussionsupporting

confidence: 89%

Value of quantitative analysis of left ventricular systolic function in patients on maintenance hemodialysis based on myocardial work technique

Liu

Feng²,

Song

et al. 2020

Preprint

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“…Although, we do aknowledge the limitations of LVEF as a measure of systolic function in patients with mitral regurgitation. Additionally, global LV longitudinal strain has been shown to be a better predictor for LV function in patients with mitral regurgitation …”

Section: Discussionmentioning

confidence: 99%

Left atrial hemodynamics and left ventricular remodeling –predictors of outcomes after Transcatheter mitral valve repair with the MitraClip device

Lazkani

Sawant

Taase

et al. 2018

Cathet Cardio Intervent

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Background Increased afterload and reduced left ventricular (LV) performance are sequela of mitral valve repair. However, hemodynamic left atrial and ventricular parameters that can predict outcome following mitral valve repair remain elusive. Methods One hundred and two consecutive patients undergoing MitraClip procedure from 2014 to 2017 at Banner University Medical Center were enrolled in this study. All patients underwent pre‐procedure echocardiograms and intra‐procedure invasive left atrial (LA) pressure monitoring. Clinical, laboratory, and procedural parameters were collected. The primary end‐point was the composite outcome of all‐cause mortality and repeat hospitalization within 90 days. Results The mean age was 77 ±10 years, the majority were Caucasians (93, 91.2%) and 47 (46.1%) were males. Thirty‐two patients (31.4%) had diabetes, 39 (38.2%) had renal insufficiency, and 38 (37.3%) had a history of congestive heart failure. The median society of thoracic surgeons score was 6.7% (Interquartile range [IQR]: 3.9, 10.2). Immediately post‐procedure there was a significant reduction in the LA pressure (Mean 12.0 vs. 18.6 mmHg, P < 0.001) and pulmonary artery systolic pressure (43.5 vs. 53.2 mmHg, P = 0.001) compared to baseline. LA pressure was an independent predictor of the composite outcome in an unadjusted (OR = 1.07, 95% CI: 1.00–1.13, P = 0.03) and adjusted (OR = 1.07, 95% CI: 1.00–1.14, P = 0.03) analysis respectively. Conclusion LA pressure drop is an independent predictor of outcome after the MitraClip procedure. This finding has implications for early identification of patients at risk of poor outcomes and instituting aggressive medical therapy and close follow‐up for avoiding hospitalizations for heart failure decompensation.

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“…Changes in the degree of MR have also been shown to predict future symptom onset. In a study of 61 asymptomatic patients with moderate to severe degenerative MR, patients with a marked increase in effective regurgitant orifice area during exercise (>10mm 2 ) had lower symptom-free survival than those in whom MR decreased or remained unchanged [58]. In addition, this group found the development of exercise induced pulmonary hypertension (PASP>60mmHg) was associated with significantly reduced 2 year survival of 35% compared to 75% in those without exercise induced PASP [59].…”

Section: Asymptomatic Severe Mitral Regurgitationmentioning

confidence: 95%

Stress echocardiography in valvular heart disease

Badiani

Lloyd

2018

Expert Review of Cardiovascular Therapy

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Myocardial Strain in Prediction of Outcomes After Surgery for Severe Mitral Regurgitation

Abstract: GLS appears to be a better predictor of cardiac events all-cause death than conventional parameters. Measuring preoperative GLS is helpful to predict post-operative outcome and determine optimal timing for surgery in patients with severe primary MR.

Cited by 110 publications

References 29 publications

Value of quantitative analysis of left ventricular systolic function in patients on maintenance hemodialysis based on myocardial work technique

Value of quantitative analysis of left ventricular systolic function in patients on maintenance hemodialysis based on myocardial work technique

Left atrial hemodynamics and left ventricular remodeling –predictors of outcomes after Transcatheter mitral valve repair with the MitraClip device

Stress echocardiography in valvular heart disease

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