Global and Regional Longitudinal Strains Predict Left Ventricular Dysfunction after Mitral Valve Repair: A Two Dimensional Speckle Tracking Study

Background: It has been well documented that reduced left ventricular ejection fraction (LVEF) has adverse effect on the outcomeof patients with severe mitral regurgitation (MR) after mitral valve repair (MVr). However, the best method for early detection ofLV dysfunction in asymptomatic or mildly symptomatic patients with MR still has not been established. Recently two dimensionalspeckle tracking echocardiography (2DSTE) has been used to identify subclinical alterations of myocardial deformation in manyclinical settings.Objectives: Our aim was to assess the value of regional and global LV two dimensional strains to predict postoperative LV dysfunctionafter MVr.Methods: Twenty six patients with severe MR were evaluated. Patients were divided into two groups according to their postoperativeLVEF difference, those with a post-op LVEF reduction of < 10% at 3 months (Group 1), and those with post-op LVEF reductionof 10% at 3 months (Group 2). All data were measured after 3 months follow-up and compared with pre-operative measures.Results: The occurrence of post-operative LV dysfunction was significantly related to left ventricular end-systolic dimension index(LVESDI), NYHA functional class and global longitudinal strain (GLS). A cut-off value of 19% for GLS could predict post-op LV dysfunctionwith a sensitivity of 89% and specificity of 77%. In addition a cut-off value of - 17.7% for long axis strain with a sensitivity of 78%and specificity of 77% and a cut off value of -20% for 2-chamber strain with a sensitivity of 77% and specificity 83% could predict LVdysfunction after MVr.Conclusions: Among all measured data LV global longitudinal strain seems to be the most sensitive predictor of postoperative LVdysfunction in patients with severe MR and normal LVEF after surgical repair.

کلیدواژه ها:

Mitral Regurgitation ، Mitral Valve Repair ، Left Ventricular Function ، Longitudinal Strain ، Two Dimensional SpeckleTracking