Global Longitudinal Strain Predicts Outcomes in Patients with Reduced Left Ventricular Function Undergoing Transcatheter Edge-to-Edge Mitral Repair
Por:
Fernandez-Peregrina, E, Asmarats, L, Estevez-Loureiro, R, Pascual, I, Bastidas, D, Benito-Gonzalez, T, Caneiro-Queija, B, Avanzas, P, De Agustin, JA, Fernandez-Vazquez, F, Barreiro-Perez, M, Leon, V, Nombela-Franco, L, Garrote, C, Li, CH, Baz, JA, Adeba, A, Sans-Rosello, J, Gualis, J, Arzamendi, D
Publicada:
1 jun 2023
Ahead of Print:
18 jun 2023
Resumen:
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 & LE;40% and severe MR treated with MitraClip were included. Four groups were generated according to the LVEF (& GE;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 & LE;2, 79.2% were at a NYHA class & LE;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.
Filiaciones:
Fernandez-Peregrina, E:
Hosp St Creu I St Pau, Intervent Cardiol Dept, Cardiol Unit, Barcelona 08025, Spain
Univ Autonoma Barcelona, Sch Med, Barcelona 08193, Spain
Asmarats, L:
Hosp St Creu I St Pau, Intervent Cardiol Dept, Cardiol Unit, Barcelona 08025, Spain
Estevez-Loureiro, R:
Hosp Alvaro Cunqueiro, Intervent Cardiol Unit, Vigo 36312, Spain
Pascual, I:
Hosp Univ Cent Asturias, Heart Area, Oviedo 33011, Spain
Bastidas, D:
Hosp Clin San Carlos, Cardiovasc Inst, IdISSC, Madrid 28040, Spain
Benito-Gonzalez, T:
Univ Hosp Leon, Dept Cardiol, Leon 24008, Spain
Caneiro-Queija, B:
Hosp Alvaro Cunqueiro, Intervent Cardiol Unit, Vigo 36312, Spain
Avanzas, P:
Hosp Univ Cent Asturias, Heart Area, Oviedo 33011, Spain
De Agustin, JA:
Hosp Clin San Carlos, Cardiovasc Inst, IdISSC, Madrid 28040, Spain
Fernandez-Vazquez, F:
Univ Hosp Leon, Dept Cardiol, Leon 24008, Spain
Barreiro-Perez, M:
Hosp Alvaro Cunqueiro, Intervent Cardiol Unit, Vigo 36312, Spain
Leon, V:
Hosp Univ Cent Asturias, Heart Area, Oviedo 33011, Spain
Nombela-Franco, L:
Hosp Clin San Carlos, Cardiovasc Inst, IdISSC, Madrid 28040, Spain
Garrote, C:
Univ Hosp Leon, Dept Cardiol, Leon 24008, Spain
Li, CH:
Hosp St Creu I St Pau, Intervent Cardiol Dept, Cardiol Unit, Barcelona 08025, Spain
Univ Autonoma Barcelona, Sch Med, Barcelona 08193, Spain
Baz, JA:
Hosp Alvaro Cunqueiro, Intervent Cardiol Unit, Vigo 36312, Spain
Adeba, A:
Hosp Univ Cent Asturias, Heart Area, Oviedo 33011, Spain
Sans-Rosello, J:
Parc Tauli Hosp Univ, Dept Cardiol, Sabadell 08208, Spain
Gualis, J:
Univ Hosp Leon, Dept Cardiol, Leon 24008, Spain
Arzamendi, D:
Hosp St Creu I St Pau, Intervent Cardiol Dept, Cardiol Unit, Barcelona 08025, Spain
Univ Autonoma Barcelona, Sch Med, Barcelona 08193, Spain
gold, Green Published, Green Accepted, All Open Access, Gold, Green
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