Prognostic value of right ventricular longitudinal strain in patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge mitral valve repair
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
AIMS: To evaluate the prognostic impact of pre-procedural right ventricular longitudinal strain (RVLS) in patients with secondary mitral regurgitation (SMR) undergoing transcatheter edge-to-edge repair (TEER) in comparison with conventional echocardiographic parameters of RV function.
METHODS AND RESULTS: This is a retrospective study including 142 patients with SMR undergoing TEER at two Italian centres. At 1-year follow-up 45 patients reached the composite endpoint of all-cause death or heart failure hospitalization. The best cut-off value of RV free-wall longitudinal strain (RVFWLS) to predict outcome was -18% [sensitivity 72%, specificity of 71%, area under curve (AUC) 0.78, P < 0.001], whereas the best cut-off value of RV global longitudinal strain (RVGLS) was -15% (sensitivity 56%, specificity 76%, AUC 0.69, P < 0.001). Prognostic performance was suboptimal for tricuspid annular plane systolic excursion, Doppler tissue imaging-derived tricuspid lateral annular systolic velocity and fractional area change (FAC). Cumulative survival free from events was lower in patients with RVFWLS ≥ -18% vs. RVFWLS < -18% (44.0% vs. 85.4%; < 0.001) as well as in patients with RVGLS ≥ -15% vs. RVGLS < -15% (54.9% vs. 81.7%; P < 0.001). At multivariable analysis FAC, RVGLS and RVFWLS were independent predictors of events. The identified cut-off of RVFWLS and RVGLS both resulted independently associated with outcomes.
CONCLUSION: RVLS is a useful and reliable tool to identify patients with SMR undergoing TEER at high risk of mortality and HF hospitalization, on top of other clinical and echocardiographic parameters, with RVFWLS offering the best prognostic performance.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
European heart journal. Cardiovascular Imaging - 24(2023), 11 vom: 27. Okt., Seite 1509-1517 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lupi, Laura [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 30.10.2023 Date Revised 03.12.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/ehjci/jead103 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356970507 |
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| 100 | 1 | |a Lupi, Laura |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prognostic value of right ventricular longitudinal strain in patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge mitral valve repair |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 03.12.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a AIMS: To evaluate the prognostic impact of pre-procedural right ventricular longitudinal strain (RVLS) in patients with secondary mitral regurgitation (SMR) undergoing transcatheter edge-to-edge repair (TEER) in comparison with conventional echocardiographic parameters of RV function | ||
| 520 | |a METHODS AND RESULTS: This is a retrospective study including 142 patients with SMR undergoing TEER at two Italian centres. At 1-year follow-up 45 patients reached the composite endpoint of all-cause death or heart failure hospitalization. The best cut-off value of RV free-wall longitudinal strain (RVFWLS) to predict outcome was -18% [sensitivity 72%, specificity of 71%, area under curve (AUC) 0.78, P < 0.001], whereas the best cut-off value of RV global longitudinal strain (RVGLS) was -15% (sensitivity 56%, specificity 76%, AUC 0.69, P < 0.001). Prognostic performance was suboptimal for tricuspid annular plane systolic excursion, Doppler tissue imaging-derived tricuspid lateral annular systolic velocity and fractional area change (FAC). Cumulative survival free from events was lower in patients with RVFWLS ≥ -18% vs. RVFWLS < -18% (44.0% vs. 85.4%; < 0.001) as well as in patients with RVGLS ≥ -15% vs. RVGLS < -15% (54.9% vs. 81.7%; P < 0.001). At multivariable analysis FAC, RVGLS and RVFWLS were independent predictors of events. The identified cut-off of RVFWLS and RVGLS both resulted independently associated with outcomes | ||
| 520 | |a CONCLUSION: RVLS is a useful and reliable tool to identify patients with SMR undergoing TEER at high risk of mortality and HF hospitalization, on top of other clinical and echocardiographic parameters, with RVFWLS offering the best prognostic performance | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a mitral transcatheter edge-to-edge repair | |
| 650 | 4 | |a right ventricular longitudinal strain | |
| 650 | 4 | |a secondary mitral regurgitation | |
| 700 | 1 | |a Italia, Leonardo |e verfasserin |4 aut | |
| 700 | 1 | |a Pagnesi, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Pancaldi, Edoardo |e verfasserin |4 aut | |
| 700 | 1 | |a Ancona, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Stella, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Pezzola, Elisa |e verfasserin |4 aut | |
| 700 | 1 | |a Cimino, Giuliana |e verfasserin |4 aut | |
| 700 | 1 | |a Saccani, Nicola |e verfasserin |4 aut | |
| 700 | 1 | |a Ingallina, Giacomo |e verfasserin |4 aut | |
| 700 | 1 | |a Margonato, Davide |e verfasserin |4 aut | |
| 700 | 1 | |a Inciardi, Riccardo Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Lombardi, Carlo Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Tomasoni, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Agricola, Eustachio |e verfasserin |4 aut | |
| 700 | 1 | |a Metra, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Adamo, Marianna |e verfasserin |4 aut | |
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