Left atrial strain and clinical outcome in patients with significant mitral regurgitation after surgical mitral valve repair
BackgroundThis study aimed to investigate the prognostic value of left atrial (LA) strain in patients with significant mitral regurgitation (MR) after surgical mitral valve (MV) repair.MethodsA total of 169 patients (age 55 ± 15 years, 88 men) with moderate or severe MR on echocardiogram at least 6...
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.985122/full |
| _version_ | 1828329170607800320 |
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| author | Se-Eun Kim Dae-Young Kim Jiwon Seo Iksung Cho Geu-Ru Hong Jong-Won Ha Chi Young Shim |
| author_facet | Se-Eun Kim Dae-Young Kim Jiwon Seo Iksung Cho Geu-Ru Hong Jong-Won Ha Chi Young Shim |
| author_sort | Se-Eun Kim |
| collection | DOAJ |
| description | BackgroundThis study aimed to investigate the prognostic value of left atrial (LA) strain in patients with significant mitral regurgitation (MR) after surgical mitral valve (MV) repair.MethodsA total of 169 patients (age 55 ± 15 years, 88 men) with moderate or severe MR on echocardiogram at least 6 months after surgical MV repair for primary MR were studied. Two-dimensional, Doppler, and speckle tracking echocardiography including MR quantitative measures, chamber size, and LA strain were comprehensively analyzed. The primary outcome was a composite of cardiovascular death, heart failure hospitalization, and MV reoperation.ResultsDuring a median of 44.4 months [interquartile range (IQR): 18.7–70.3 months] of follow-up, 44 patients (26%) experienced clinical events; these patients had greater MR volume, elevated mean diastolic pressure gradient and pulmonary artery systolic pressure, and enlarged chamber size compared with patients who did not experience events. Patients with events showed significantly lower LA strain [13.3% (IQR: 9.3–23.8%) vs. 24.0% (IQR: 13.1–31.4%), p = 0.003] and higher MR volume/LA strain [3.09 ml/% (IQR: 2.06–5.80 ml/%) vs. 1.57 ml/% (IQR: 1.04–2.72 ml/%), p < 0.001] than those without events. MR volume/LA strain was a good predictor of clinical outcomes (cut-off 1.57 ml/%, area under the curve 0.754, p < 0.001). On multivariable Cox proportional analysis, MR volume/LA strain was independently associated with clinical outcomes (hazard ratio: 1.269, 95% confidence interval: 1.109–1.452, p < 0.001) along with pulmonary artery systolic pressure.ConclusionA measure of LA mechanical function relative to MR volume is associated with clinical outcomes in patients with significant MR after surgical MV repair. |
| first_indexed | 2024-04-13T20:20:37Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-04-13T20:20:37Z |
| publishDate | 2022-10-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-0db8120f76e3490f91986591d95df99b2022-12-22T02:31:33ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-10-01910.3389/fcvm.2022.985122985122Left atrial strain and clinical outcome in patients with significant mitral regurgitation after surgical mitral valve repairSe-Eun Kim0Dae-Young Kim1Jiwon Seo2Iksung Cho3Geu-Ru Hong4Jong-Won Ha5Chi Young Shim6Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaBackgroundThis study aimed to investigate the prognostic value of left atrial (LA) strain in patients with significant mitral regurgitation (MR) after surgical mitral valve (MV) repair.MethodsA total of 169 patients (age 55 ± 15 years, 88 men) with moderate or severe MR on echocardiogram at least 6 months after surgical MV repair for primary MR were studied. Two-dimensional, Doppler, and speckle tracking echocardiography including MR quantitative measures, chamber size, and LA strain were comprehensively analyzed. The primary outcome was a composite of cardiovascular death, heart failure hospitalization, and MV reoperation.ResultsDuring a median of 44.4 months [interquartile range (IQR): 18.7–70.3 months] of follow-up, 44 patients (26%) experienced clinical events; these patients had greater MR volume, elevated mean diastolic pressure gradient and pulmonary artery systolic pressure, and enlarged chamber size compared with patients who did not experience events. Patients with events showed significantly lower LA strain [13.3% (IQR: 9.3–23.8%) vs. 24.0% (IQR: 13.1–31.4%), p = 0.003] and higher MR volume/LA strain [3.09 ml/% (IQR: 2.06–5.80 ml/%) vs. 1.57 ml/% (IQR: 1.04–2.72 ml/%), p < 0.001] than those without events. MR volume/LA strain was a good predictor of clinical outcomes (cut-off 1.57 ml/%, area under the curve 0.754, p < 0.001). On multivariable Cox proportional analysis, MR volume/LA strain was independently associated with clinical outcomes (hazard ratio: 1.269, 95% confidence interval: 1.109–1.452, p < 0.001) along with pulmonary artery systolic pressure.ConclusionA measure of LA mechanical function relative to MR volume is associated with clinical outcomes in patients with significant MR after surgical MV repair.https://www.frontiersin.org/articles/10.3389/fcvm.2022.985122/fullmitral valve repair (MV repair)mitral regurgitation (MR)left atrial strain (LA strain)speckle tracking echocardiographyoutcome |
| spellingShingle | Se-Eun Kim Dae-Young Kim Jiwon Seo Iksung Cho Geu-Ru Hong Jong-Won Ha Chi Young Shim Left atrial strain and clinical outcome in patients with significant mitral regurgitation after surgical mitral valve repair Frontiers in Cardiovascular Medicine mitral valve repair (MV repair) mitral regurgitation (MR) left atrial strain (LA strain) speckle tracking echocardiography outcome |
| title | Left atrial strain and clinical outcome in patients with significant mitral regurgitation after surgical mitral valve repair |
| title_full | Left atrial strain and clinical outcome in patients with significant mitral regurgitation after surgical mitral valve repair |
| title_fullStr | Left atrial strain and clinical outcome in patients with significant mitral regurgitation after surgical mitral valve repair |
| title_full_unstemmed | Left atrial strain and clinical outcome in patients with significant mitral regurgitation after surgical mitral valve repair |
| title_short | Left atrial strain and clinical outcome in patients with significant mitral regurgitation after surgical mitral valve repair |
| title_sort | left atrial strain and clinical outcome in patients with significant mitral regurgitation after surgical mitral valve repair |
| topic | mitral valve repair (MV repair) mitral regurgitation (MR) left atrial strain (LA strain) speckle tracking echocardiography outcome |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.985122/full |
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