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Prognostic Implications of Left Ventricular Global Longitudinal Strain in Patients With Surgically Treated Mitral Valve Disease and Preserved Ejection Fraction

Authors
 Seon Hwa Lee  ;  Purevjargal Lhagvasuren  ;  Jiwon Seo  ;  Iksung Cho  ;  Dae-Young Kim  ;  Geu-Ru Hong  ;  Jong-Won Ha  ;  Chi Young Shim 
Citation
 FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol.8 : 775533, 2022-01 
Journal Title
FRONTIERS IN CARDIOVASCULAR MEDICINE
Issue Date
2022-01
Keywords
left ventricular global longitudinal strain/LV-GLS ; mitral valve surgery ; outcome ; post-operation ; preserved left ventricular ejection fraction
Abstract
Background: This study investigated whether left ventricular (LV) global longitudinal strain (LV-GLS), as an LV function parameter less affected by mitral valve (MV) repair or prosthesis, is associated with clinical outcomes in patients with surgically treated MV disease.

Methods: Among 750 patients who underwent MV surgery, we assessed LV-GLS by speckle tracking echocardiography in 344 patients (148 men, mean age 58 ± 13 years) who showed preserved LV ejection fraction on echocardiography between 6 months and 2 years after MV surgery and who did not undergo aortic valve surgery. The assessed clinical events included admission for worsening of heart failure and cardiac death.

Results: During a period of 42.4 ± 26.0 months, 32 (9.3%) patients were hospitalized for worsening heart failure, and 3 (0.8%) died due to cardiac causes. The absolute value of LV-GLS (
LV-GLS
) was significantly lower in patients with clinical events than in those without (12.1 ± 3.1 vs. 15.0 ± 3.2%, p < 0.001) despite comparable LV ejection fraction between groups.
LV-GLS
showed predictive value for clinical events (cut-off 13.9%, area under the curve 0.744, p < 0.001). Patients with
LV-GLS
≤14.0% had poorer outcomes than those with
LV-GLS
>14.0% (log-rank p < 0.001). Prognosis was worse in patients with
LV-GLS
≤14.0% and pulmonary hypertension than among those who with
LV-GLS
≤14.0% without pulmonary hypertension (log rank p < 0.001). In nested Cox proportional hazard regression models, reduced
LV-GLS
was independently associated with the occurrence of clinical events.

Conclusions: In patients with surgically treated MV and preserved LV ejection fraction, assessment of LV-GLS provides functional information associated with cardiovascular outcomes.
Files in This Item:
T202200365.pdf Download
DOI
10.3389/fcvm.2021.775533
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae-Young(김대영)
Seo, Jiwon(서지원) ORCID logo https://orcid.org/0000-0002-7641-3739
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Lee, Seonhwa(이선화)
Cho, Ik Sung(조익성)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187971
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