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首页> 外文期刊>European heart journal cardiovascular Imaging >Global longitudinal strain predicts left ventricular dysfunction after mitral valve repair
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Global longitudinal strain predicts left ventricular dysfunction after mitral valve repair

机译：全球纵向应变预测二尖瓣修复后左心功能不全

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Aims: Despite a successful surgical procedure and adherence to current recommendations, postoperative left ventricular (LV) dysfunction after mitral valve repair (MVr) for organic mitral regurgitation (MR) may still occur. New approaches are therefore needed to detect subclinical preoperative LV dysfunction. LV global longitudinal strain (GLS), assessed with speckle-tracking echocardiographic analysis, has been proposed as a novel measure to better depict latent LV dysfunction. The aim of this study was to investigate the value of GLS to predict long-term LV dysfunction after MVr. Methods and results: A total of 233 patients (61% men, 61 ± 12 years) with moderate-severe organic MR who underwent successful MVr between 2000 and 2009 were included. Echocardiography was performed at baseline and long-term follow-up (34 ± 20 months) after MVr. LV dysfunction at follow-up was defined as LV ejection fraction (EF) <50% and was present in 29 (12%) patients. A cut-off value of -19.9% of GLS showed a sensitivity and specificity of 90 and 79% to predict long-term LV dysfunction. By univariate logistic regression analysis, baseline LVEF ≤60%, LV end-systolic diameter (ESD) ≥40 mm, atrial fibrillation, presence of symptoms, and GLS >-19.9% were predictors of long-term LV dysfunction. By multivariate analysis, GLS remained an independent predictor of LV dysfunction (odds ratio 23.16, 95% confidence interval: 6.53-82.10, P < 0.001), together with LVESD. Conclusion: In a large series of patients operated within the last decade, MVr resulted in a low incidence of long-term LV dysfunction. A GLS of >-19.9% demonstrated to be a major independent predictor of long-term LV dysfunction after adjustment for parameters currently implemented into guidelines. All rights reserved.
机译：目的：尽管手术方法成功并且遵守了当前的建议，二尖瓣修复（MVr）后进行的二尖瓣反流（MR）仍可能发生术后左心室（LV）功能障碍。因此，需要新的方法来检测亚临床的术前左室功能不全。 LV总体纵向应变（GLS），通过斑点跟踪超声心动图分析评估，已被提议作为一种更好地描述潜在LV功能障碍的新方法。这项研究的目的是调查GLS在预测MVr后长期左室功能不全方面的价值。方法和结果：共纳入233例2000年至2009年间成功进行MVr的中度重度器质性MR患者（61％男性，61±12岁）。超声心动图是在MVr后的基线和长期随访（34±20个月）进行的。随访时左室功能不全定义为左室射血分数（EF）<50％，并在29名（12％）患者中出现。 GLS的临界值为-19.9％，其敏感性和特异性分别为90％和79％，可预测长期的LV功能障碍。通过单因素逻辑回归分析，基线LVEF≤60％，LV收缩末期直径（ESD）≥40mm，房颤，症状的存在以及GLS> -19.9％是长期LV功能障碍的预测指标。通过多变量分析，GLS仍是LVESD的独立预测指标（赔率23.16，95％置信区间：6.53-82.10，P <0.001）。结论：在过去的十年中，大量手术患者中，MVr导致长期左室功能障碍的发生率较低。调整当前实施指南中的参数后，GLS> -19.9％是长期LV功能障碍的主要独立预测指标。版权所有。

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