Prognostic Impact of Left Atrial Strain After Mitral Valve Repair Surgery in Patients With Severe Mitral Regurgitation
- Author:
Jin Kyung OH
1
;
Yong-Hoon YOON
;
Jae-Hyung ROH
;
Minsu KIM
;
Byung Joo SUN
;
Sung-Ho JUNG
;
Jae Hwan LEE
;
Jae Won LEE
;
Dae-Hee KIM
;
Jae-Hyeong PARK
Author Information
- Publication Type:Original Research
- From:Korean Circulation Journal 2022;52(3):205-217
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background and Objectives:The prognostic value of left atrial (LA) function in terms of long-term clinical outcomes after mitral regurgitation (MR) surgery remains unclear.Therefore, we investigated the impact of preoperative LA global longitudinal strain (LAGLS) on the long-term postoperative clinical outcomes in chronic severe MR patients who underwent mitral valve (MV) repair surgery.
Methods:From January 2012 to December 2017, we analyzed 338 patients (mean age, 51.9±12.5 years; 218 males [64.5%]) treated with MV repair surgery for severe MR. The primary outcome was cardiovascular events, defined as the composite of all-cause death, newly developed atrial fibrillation (AF), and re-hospitalization for cardiovascular causes.
Results:During a median follow-up of 45 months (interquartile range, 26–65), 30 (8.9%) cardiovascular events, 5 (1.5%) all-cause death, 8 (2.4%) newly developed AF, and 26 (7.7%) re-hospitalizations occurred. On multivariable analysis, baseline LAGLS was an independent predictor of cardiovascular events (adjusted hazard ratio [HR], 0.91; 95% confidential interval [CI], 0.85–0.97; p=0.004) and re-hospitalization (adjusted HR, 0.93; 95% CI,0.86–1.00; p=0.037). According to the optimal cutoff value of LAGLS, patients with low LAGLS (<23.6%) had a significantly higher risk of cardiovascular events (adjusted HR, 2.70;95% CI, 1.04–7.00; p=0.041) than those with high LAGLS (≥23.6%). In a subgroup analysis, patients with high LAGLS had better clinical outcomes regardless of whether the patient had a LA volume index <60 mL/m2 .
Conclusions:In patients with chronic severe MR who received successful MV repair surgery, preoperative LAGLS is an independent predictor of long-term postoperative outcomes.
