Global Longitudinal Strain Predicts Outcomes in Patients with Reduced Left Ventricular Function 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 myoc...

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Autores: Fernández-Peregrina, Estefanía|||0000-0002-3025-8251, Asmarats, Lluís|||0000-0002-3357-5834, Estevez-Loureiro, Rodrigo|||0000-0001-5841-5514, Pascual, Isaac|||0000-0001-5433-1364, Bastidas, Diana, Benito-González, Tomás|||0000-0002-8428-9248, Caneiro-Queija, Berenice, Avanzas, Pablo|||0000-0002-4958-6108, Agustin, Jose Alberto de|||0000-0002-4444-9622, Fernández-Vázquez, Felipe|||0000-0001-7187-1290, Barreiro-Pérez, Manuel|||0000-0001-7489-2935, Leon, Victor|||0000-0002-0173-6744, Nombela-Franco, Luís|||0000-0003-3438-8907, Garrote, Carmen, Li, Chi Hion|||0000-0001-7556-3711, Baz, José Antonio, Adeba, Antonio|||0000-0001-8890-946X, Sans-Roselló, Jordi|||0000-0003-3176-6191, Gualis, Javier|||0000-0002-3680-6431, Arzamendi, Dabit|||0000-0001-7543-5867
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:290203
Acceso en línea:https://ddd.uab.cat/record/290203
https://dx.doi.org/urn:doi:10.3390/jcm12124116
Access Level:acceso abierto
Palabra clave:Left ventricular global longitudinal strain
MitraClip
Mitral regurgitation
Descripción
Sumario: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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