Key result
Among patients with LVEF <30% undergoing MitraClip repair, worse baseline left ventricular global longitudinal strain was an independent predictor of cardiovascular mortality (HR 3.3, 95% CI 1.1-10, p=0.023).
Why the study?
Optimal patient selection and timing for mitral transcatheter edge-to-edge valve repair remain uncertain, especially in patients with severely depressed LVEF.
Does baseline left ventricular global longitudinal strain predict cardiovascular mortality in patients with severe mitral regurgitation and reduced LVEF undergoing transcatheter edge-to-edge mitral repair?
Cohort (n=172)
Yes
Does baseline left ventricular global longitudinal strain predict cardiovascular mortality in patients with severe mitral regurgitation and reduced LVEF undergoing transcatheter edge-to-edge mitral repair?
Answers are grounded in this paper and cite their sources.
Baseline global longitudinal strain assessment provides independent prognostic value for cardiovascular mortality in patients with severely reduced LVEF undergoing transcatheter edge-to-edge mitral repair.
Background: The timing and selection of optimal candidates for mitral transcatheter edge-to-edge valve repair remains to be fully determined, especially in cases with severely depressed left ventricular ejection fraction (LVEF). The objective of this study is to evaluate the prognostic value of myocardial strain (LVGLS) in this setting. Methods: Retrospectively, 172 consecutive patients with LVEF ≤40% and severe MR treated with MitraClip were included. Four groups were generated according to the LVEF (<30% or ≥30%) and median LVGLS. The primary end-point was cardiovascular mortality. Results: Procedural success was high (96.5%) and complications were rare. At one-year follow-up, 82.5% of patients maintained MR grade ≤2, 79.2% were at a NYHA class ≤II and a reduction of 80% in heart failure admissions was observed in all groups. Interestingly, among patients with a more depressed LVEF, LVGLS was found to be an independent predictor for cardiovascular mortality (HR: 3.3; 95% CI: 1.1–10, p = 0.023). Conclusions: Mitral valve repair with MitraClip is safe and it improves the mid-term functional class of patients regardless of LVEF. LVGLS can help in the selection of optimal candidates and timing for this procedure, as well as in the recognition of those patients with worse prognoses.
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Fernández‐Peregrina et al. (2023) conducted a cohort in Severe mitral regurgitation with reduced LVEF (≤40%) (n=172). Worse left ventricular global longitudinal strain (LVGLS < -8.4%) vs. More preserved LVGLS (≥ -8.4%) was evaluated on Cardiovascular mortality (HR 3.3, 95% CI 1.1-10, p=0.023). Among patients with LVEF <30% undergoing MitraClip repair, worse baseline left ventricular global longitudinal strain was an independent predictor of cardiovascular mortality (HR 3.3, 95% CI 1.1-10, p=0.023).
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