Page 53 - Advanced echocardiography in characterization and management of patients with secondary mitral regurgitation

2D transthoracic echocardiography using the apical 4-chamber, 2-chamber, and long- axis views of the LV (12). LV GLS was determined offline using commercially available software (EchoPAC 201.0.0). LV GLS measures the shortening of the myocardial fibers and is presented as negative values conventionally: more negative values indicate better systolic function (shortening), whereas less negative values, closer to 0, indicate more impaired systolic function. However, in this study, absolute values of LV GLS are presented (Figure 1). The intraclass correlation coefficients for the interobserver and intraobserver reproducibility of LV GLS measurements in this population was 0.89 (95% confidence interval [CI]: 0.63 to 0.96; p < 0.001) and 0.93 (95% CI: 0.84 to 0.97; p < 0.001), respectively.
Figure 1. Measurement of LV GLS in Patients With Secondary MR
(A) A 59-year old patient with ischemic cardiomyopathy, in New York Heart Association functional class IV with severe mitral regurgitation (MR) and a left ventricular ejection fraction (LVEF) of 21%. (B) A patient with severe MR and an LVEF of 20%. Despite having the same degree of MR and a comparable LVEF, the LV global longitudinal strain (GLS) was highly different, which demonstrates that patient in A had a better LV systolic function when compared with the patient in B.
Follow-up
Patients were followed-up for the primary endpoint of all-cause mortality. Data on mortality were obtained from the departmental cardiology information system (EPD- Vision 11.8.4.0), which is linked to the governmental death registry database. Follow-up data were complete for all patients.
Statistical analysis
Categorical data are presented as absolute numbers and percentages. Continuous data are presented as mean ± SD when normally distributed or as median with interquartile range, when not normally distributed. To compare baseline characteristics between 2
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