A new echocardiographic score including RVAc<0.50, LAr strain<20%, LVEF<60%, age>65, and symptoms predicted 1-year mortality with AUC 0.83 in 349 PMR surgery patients.
Does a novel echocardiographic risk score predict postoperative mortality in patients undergoing primary mitral regurgitation surgery?
A novel risk score incorporating advanced echocardiographic parameters (RVAc, LAr strain, LVEF) alongside age and symptoms accurately predicts 1-year and long-term mortality in patients undergoing primary mitral regurgitation surgery.
Absolute Event Rate: 0% vs 0%
Abstract Background Despite the availability of several risk scores for cardiac surgery in primary mitral regurgitation (PMR), accurately predicting adverse events remains challenging. Purpose This study aimed to develop a new predictive score for postoperative mortality by incorporating advanced functional echocardiographic parameters. Methods We conducted a retrospective analysis of a prospective cohort of PMR patients who underwent mitral valve surgery at a tertiary care center between 2014 and 2022. Echocardiographic data from studies performed within six months before surgery were analyzed. One-year and long-term mortality were assessed using logistic and Cox regression models to identify significant predictors of outcomes. Results A total of 349 patients were included (median EuroSCORE II: 2.3 1.1–5.0; mean age: 68.5 ± 12.4 years; 55.9% male). Mean left ventricular ejection fraction (LVEF) was 60% ± 9.4%. Mean follow-up was 3.28 ± 2 years. One-year mortality occurred in 29 patients (8.3%), while all-cause mortality during follow-up was 59 patients (16.9%). Patients who died within the first year were older and had significantly lower left atrial reservoir (LAr) strain, higher right ventricular systolic pressure (RVSP), and reduced right ventricular-arterial coupling (RVAc) (Figure 1). Multivariable regression analysis identified the following independent predictors of mortality:• RVAc 0.50• LAr strain 20%• LVEF 60%• Age 65 years• Preoperative symptoms The risk model stratified patients into quartiles, with an area under the ROC curve of 0.830 (95% CI 0.774–0.885) for 1-year mortality and 0.832 (95% CI 0.781–0.884) for long-term mortality (Figure 2). Conclusions A novel predictive score integrating left atrial and ventricular function along with right ventricular-arterial coupling effectively predicts all-cause mortality in PMR patients undergoing surgery. External validation is needed to confirm its clinical utility.
Zapata et al. (Sat,) reported a other. A new echocardiographic score including RVAc<0.50, LAr strain<20%, LVEF<60%, age>65, and symptoms predicted 1-year mortality with AUC 0.83 in 349 PMR surgery patients.