Abstract 224: Preoperative Systolic Strain Rate Predicts Postoperative Left Ventricular Systolic Function in Patients With Chronic Mitral Regurgitation: 18 Months Follow up Study
Postoperative left ventricular (LV) function is an important prognostic factor in patients with mitral regurgitation (MR). Currently, there is no specific diagnostic method that determine optimum time for surgery before development of myocardial damage. Strain rate (SR) imaging is a recent technique which is very sensitive in detecting regional systolic abnormalities and may allow diagnosis of subclinical changes of LV function.
Aim: To investigate value of preoperative regional myocardial peak systolic SR to define optmimal time for surgery and to predict postoperative LV systolic function.
Methods: 35 patients (age 55±11) with chronic MR and NYHA I/II who underwent mitral valve repair//replacement was studied. A standard echo examination, extended with Tissue Doppler, was performed before and 3, 6, 12 and 18 months after surgery. To assess LV longitudinal deformation, SR data were acquired from the mid septum and lateral walls (LW).
Results: All patients presented with preserved preoperative systolic function before surgery (EF>50%). They were divided into 2 groups based on post-operative EF: Group 1 with EF>50% and Group 2 with EF<50%. Group 1 had a significantly (p<0.005) higher preoperative peak systolic SR (LW: 1.86±0.49s-1; Septum: −1.52±0.28s-1) compared to Group 2 (LW: 0.92±0.23s-1;septum: −0.97±0.23s-1). Significant correlation was detected between preoperative SR and postoperative EF (R-0.71, p<0.0001). For detecting subclinical changes in deformation of LW, SR≤1.20 s-1 had 87% sensitivity and 90% specificity; in septum SR≤1.21 s-1 had 84% sensitivity and 88% specificity.
Conclusion: SR imaging detects subclinical changes in LV function before they can be detected by global standard parameters and might thus be used to optimize the timing of surgery.