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

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Imaging

Background:

• Mitral transcatheter edge-to-edge repair (TEER) selection is challenging in patients with severely depressed left ventricular ejection fraction (LVEF).
• Prognostic value of myocardial strain, specifically left ventricular global longitudinal strain (LVGLS), needs further evaluation in this patient cohort.

Purpose of the Study:

• To assess the prognostic significance of LVGLS in patients with LVEF ≤40% undergoing TEER with MitraClip.
• To determine if LVGLS can aid in identifying patients at higher risk of cardiovascular mortality.

Main Methods:

• Retrospective analysis of 172 patients with LVEF ≤40% and severe mitral regurgitation (MR) treated with MitraClip.
• Patients were stratified by LVEF (<30% or ≥30%) and median LVGLS.
• Primary endpoint was cardiovascular mortality.

Main Results:

• High procedural success rate (96.5%) and low complication rates.
• One-year follow-up showed sustained MR reduction, improved NYHA class, and reduced heart failure admissions.
• LVGLS independently predicted cardiovascular mortality in patients with severely depressed LVEF (HR: 3.3; p=0.023).

Conclusions:

• MitraClip TEER is safe and improves functional status in patients with reduced LVEF.
• LVGLS is a valuable tool for selecting optimal candidates and timing for TEER.
• LVGLS assists in identifying patients with a worse prognosis who may benefit from closer monitoring or alternative strategies.