Key result
Multichamber STE staging linked to ~68% higher periprocedural risk per stage in severe degenerative MR.
Why the study?
Current 2D echocardiographic indices often identify advanced myocardial injury in severe primary mitral regurgitation, whereas speckle-tracking echocardiography may detect earlier, reversible dysfunction.
Does a multichamber STE-based staging system improve risk stratification for periprocedural adverse events in patients with severe degenerative mitral regurgitation undergoing surgery?
Cohort (n=300)
Yes
Does a multichamber STE-based staging system improve risk stratification for periprocedural adverse events in patients with severe degenerative mitral regurgitation undergoing surgery?
Odds Ratio: 1.68 (95% CI 1.24–2.32)
p-value: p=0.001
A multichamber speckle-tracking echocardiography staging system provides incremental prognostic value over conventional parameters for predicting periprocedural adverse events in patients undergoing surgery for severe degenerative mitral regurgitation.
May refine periprocedural risk stratification in severe degenerative mitral regurgitation; hypothesis-generating and requires prospective validation.
AIMS: In asymptomatic patients with severe primary mitral regurgitation, surgical referral is based on 2D echocardiographic indices that often identify advanced myocardial injury. Speckle-tracking echocardiography (STE) may detect earlier, reversible dysfunction.This study evaluated whether a novel multichamber STE-based staging system of extra-valvular cardiac damage improves risk stratification in patients with severe degenerative mitral regurgitation undergoing surgery. METHODS AND RESULTS: A retrospective multicenter cohort study of patients with degenerative mitral regurgitation undergoing surgery: derivation cohort (n = 208; mean age 64 ± 13 years; 59.7% men) and validation cohort (n = 92; mean age 63 ± 12 years; 53.3% men). Receiver-operating characteristic curve analysis identified optimal strain cut-offs associated with adverse outcomes: left ventricular global longitudinal strain (LVGLS) less than 20%, peak atrial longitudinal strain (PALS) less than 25%, and right ventricular free-wall longitudinal strain (RVFWLS) less than 17%. Patients were classified into four stages: Stage 0, no damage; Stage 1, left atrial damage (PALS < 25%); Stage 2, left ventricular damage (LVGLS < 20%); Stage 3, right ventricular damage (RVFWLS < 17%).The STE-based staging system was independently associated with the composite of periprocedural adverse events (mortality, stroke, myocardial infarction, acute kidney injury, life-threatening bleeding or sepsis/wound infection requiring reintervention, complete atrioventricular block requiring pacemaker implantation): odds ratio 1.68 per stage increase (confidence interval 1.24-2.32; P = 0.001). Predictive accuracy was higher compared with clinical and echocardiographic data, with consistent results in the validation cohort. CONCLUSIONS: The multichamber STE staging system provides incremental prognostic information beyond conventional parameters, improving perioperative risk stratification.
No takes yet. Share an insight, caveat, or question.
Pasquini et al. (2026) conducted a cohort in Severe degenerative mitral regurgitation (n=300). Multichamber STE-based staging system vs. Lower stages was evaluated on Composite of periprocedural adverse events (mortality, stroke, myocardial infarction, acute kidney injury, life-threatening bleeding or sepsis/wound infection requiring reintervention, complete atrioventricular block requiring pacemaker implantation) (OR 1.68, 95% CI 1.24-2.32, p=0.001). A multichamber STE-based staging system was associated with periprocedural adverse events in severe degenerative mitral regurgitation (OR 1.68 per stage increase; 95% CI 1.24-2.32; P=0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: