Noninvasive Myocardial Work Predicts Long-Term Postinterventional Outcomes in Patients With Primary Mitral...

Area of Science:

• Cardiology
• Echocardiography
• Cardiac Mechanics

Background:

• Accurate identification of impaired left ventricular (LV) function is crucial for timely intervention in primary mitral regurgitation.
• Myocardial work, derived from noninvasive pressure-strain loops, is a novel approach to assess LV performance.
• This study investigates the diagnostic and prognostic utility of myocardial work parameters in these patients.

Purpose of the Study:

• To evaluate myocardial work parameters in patients with severe primary mitral regurgitation.
• To explore the association of myocardial work with postinterventional LV ejection fraction.
• To assess the relationship between myocardial work and clinical composite events after intervention.

Main Methods:

• Prospective enrollment of 180 patients with severe primary mitral regurgitation.
• Follow-up for postinterventional LV function (>12 months) and clinical events (24 months).
• Logistic regression and Cox proportional hazards regression analyses were employed.

Main Results:

• Patients with postinterventional LV ejection fraction <50% had significantly lower LV global longitudinal strain, global work index (GWI), global constructive work (GCW), and global work efficiency.
• Preinterventional LV global longitudinal strain, GWI, GCW, and global work efficiency independently predicted postinterventional LV dysfunction.
• Myocardial work parameters demonstrated stronger predictive power for LV dysfunction than LV ejection fraction alone and were associated with clinical events.

Conclusions:

• Myocardial work parameters, particularly GWI, GCW, and global work efficiency, serve as independent predictors of postinterventional LV dysfunction.
• These parameters are significantly associated with the occurrence of postinterventional clinical composite events.
• Myocardial work offers valuable insights into LV performance and prognosis in patients with mitral regurgitation.