Abstract 15014: Global Longitudinal Strain in Mitral Valve Regurgitation as Marker of Cardiac Damage. An Experience From the European Registry of Mitral Regurgitation
Introduction: The search of reliable echocardiographic parameters in patients with mitral regurgitation (MR) is fundamental for both management and prognostic stratification.
Hypothesis: To compare global longitudinal strain (GLS) and left ventricular ejection fraction (LVEF) in detecting cardiac damage and their relationships with echocardiographic structural and functional parameters in patients (pts) with different degree of MR.
Methods: 400 consecutive pts (age = 62.1±15.1 years, F/M = 218/182) with MR were assessed by complete echocardiographic exam during a 2-month period of enrollment for an European Registry of MR. 340 patients had degenerative MR, 42 secondary MR (due to ischemia or to cardiomyopathies) and 18 mixed MR (class III according to the Carpentier classification). MR was mild in 309 pts, moderate in 85 and severe in 6. All standard echocardiographic parameters and two-dimensional derived GLS were calculated. Comparison of the main echocardiographic parameters between pts with mild and moderate to severe MR was performed.
Results: GLS was quantifiable in 351/400 MR pts (89.3%). LVEF was 60.7±6.6% in mild MR, 53.5±12.3% in moderate MR and 51.8±11.2% in severe MR (p<0.0001). GLS was -20.1±4.6%, 17.2±5.2% and -17.1±6.5% respectively (p<0.0001). LVEF and GLS were related to each other in the pooled population (r=0.44, p<0.0001). In pts with mild MR, LVEF and GLS were both significantly related only with LV end-systolic volume (ESV) (r=-0.51 and r=0.21, both p<0.0001). In pts with moderate to severe MR LVEF was significantly related with both end-diastolic volume (EDV) (r=-0.27, p<0.01) and ESV (r=-0.57, p<0.0001) whereas GLS was related with left atrial (LA) volume (r=0.34, p<0.001), EDV (r=0.51) and ESV (r=0.69) (both p<0.0001) and with pulmonary arterial systolic pressure (PAPs) (r=0.28, p<0.01). All these relations remained significant after adjusting for age , body mass index and for MR aetiology (degenerative, secondary or mixed) in separate multiple linear regression analyses.
Conclusions: GLS appears to be a powerful hallmark of cardiac damage in pts with moderate to severe MR. GLS is independently associated with LA volume, LV EDV, ESV and PAPS degree. These associations are also irrespective of MR aetiology.
Author Disclosures: C. Santoro: None. A. Buonauro: None. R. Esposito: None. J. Monteagudo: None. B. Trimarco: None. M. Galderisi: None. J. Zamorano: None.
- © 2016 by American Heart Association, Inc.