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

Document Type : Original Article

Authors

Cardiology Department, Faculty of Medicine, Benha University, Benha, Egypt.

Abstract

Background: Severe primary mitral regurgitation (MR) poses a significant clinical challenge, and surgical correction is often necessary to improve outcomes. However, the ability to predict post-surgical results is still a critical concern. This research aimed to investigate the function of myocardial strain, specifically global longitudinal strain (GLS), in predicting outcomes after surgery for severe MR. Methods: This prospective cohort research was undertaken on 104 individuals with severe primary MR who had repair or replacement of the mitral valve. Transthoracic echocardiography and speckle-tracking analysis were conducted to assess myocardial strain. Results: Patients experiencing the primary endpoint (a composite of rehospitalization for heart failure, cardiac mortality, and redo surgery) demonstrated significantly lower baseline GLS (-14.1 ± 3.4 vs. -18.3 ± 2.5, P-value < 0.001) compared to those without the endpoint. ROC analysis exhibited that baseline GLS was an excellent predictor of the primary endpoint (AUC = 0.846, P-value < 0.001). Multivariate logistic regression confirmed that baseline GLS was a significant predictor of the primary endpoint (OR = 0.566, 95% CI = 0.445 – 0.719, P-value < 0.001). Kaplan-Meier analysis exhibited that patients with GLS ≤ 17.9 had significantly lower endpoint-free survival rates. Conclusion: GLS seems to be a more accurate predictor of cardiac events than all-cause mortality following surgery for severe MR. In patients with severe primary MR, measuring preoperative GLS is useful for predicting postoperative prognosis and deciding the appropriate schedule for surgery.

Keywords

Benha Medical Journal
Volume 42, Issue 2
(special issue cardiology)
February 2025
Pages 133-145

Files

Share

How to cite

Statistics