Page 57 - Advanced echocardiography in characterization and management of patients with secondary mitral regurgitation

Table 3. Data on Device and Invasive Mitral Valve Treatment Received During Follow-Up
Total Population (N = 650)
453 (70)
380 (59) 177 (27) 3 (1)
90 (14)
47 (7) 117 (18) 16 (3)
60 (9)
23 (4)
Values are n (%). Patients were divided according to less impaired LV GLS (≥7.0%) vs. more impaired LV
GLS (<7.0%).
AVR = aortic valve replacement; CABG = coronary artery bypass grafting; CRT = cardiac resynchronization therapy; GLS = global longitudinal strain; MVr = surgical mitral valve repair; MVR = mitral valve replacement; TVP = tricuspid valvuloplasty.
∗ Device implanted before invasive mitral valve treatment. † With mitral valve treatment.
Survival analysis
Patients with more impaired LV GLS (<7.0%) experienced significantly higher mortality rates as compared with patients with more preserved LV GLS (≥7.0%) (13%, 23%, and 44% vs. 5%, 14%, and 31% at 1-, 2-, and 5-year follow-up, respectively; p < 0.001) (Figure 3). To investigate the association between LV GLS and all-cause mortality, a Cox proportional hazards model was constructed (Table 4). LVEF was introduced as categorical variable, taking the threshold of LVEF of 30% proposed by current guidelines (3). In addition, LV GLS was also introduced as a categorical variable, taking the threshold derived from the spline curve analysis. On multivariable analysis, age, impaired renal function, diabetes mellitus, the use of diuretics, and LV end-diastolic volume index were independently associated with all-cause mortality. Furthermore, more impaired LV GLS (<7.0%) remained independently associated with all-cause mortality (HR: 1.337; 95% CI: 1.038 to 1.722; p = 0.024), whereas LVEF ≤30% was not associated with the outcome (HR: 1.055; 95% CI: 0.794 to 1.403; p = 0.711).
Device therapy CRT
Valvular intervention None
MVr
MVR
Percutaneous edge-to-edge mitral valve repair
Concomitant procedure CABG
TVP
LV reconstruction, Dor procedure
CorCap
GLS ≥7.0% (n = 349)
221 (63)
186 (53) 110 (32) 2 (1)
51 (15)
34 (10) 71 (20) 6 (2)
24 (7)
GLS <7.0% (n = 301)
232 (77)
194 (65) 67 (22) 1 (<1) 39 (13)
13 (4) 46 (15) 10 (3)
36 (12)
p Value
<0.001
0.004 0.008 0.651 0.542
0.008 0.094 0.188
0.026
Surgical MAZE
12 (3)
11 (4)
0.882
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Ch 3