Prognostic value of left atrial reservoir function in patients with severe primary mitral regurgitation undergoing mitral valve repair.

Autor:	Stassen J; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.; Department of Cardiology, Jessa Hospital Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium., van Wijngaarden AL; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands., Butcher SC; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.; Department of Cardiology, Royal Perth Hospital, 197 Wellington St, Perth WA 6000, Australia., Palmen M; Department of Thoracic Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands., Herbots L; Department of Cardiology, Jessa Hospital Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium., Bax JJ; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.; Department of Cardiology, Turku Heart Center, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, FI-20520, Turku, Finland., Delgado V; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands., Ajmone Marsan N; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2022 Dec 19; Vol. 24 (1), pp. 142-151.
DOI:	10.1093/ehjci/jeac058
Abstrakt:	Aims: Mitral regurgitation (MR) has a significant haemodynamic impact on the left atrium. Assessment of left atrial reservoir strain (LARS) may have important prognostic implications, incremental to left atrial (LA) volume, and conventional parameters of left ventricular (LV) structure and function. This study investigated whether preoperative assessment of LARS by speckle tracking echocardiography is associated with long-term outcomes in patients undergoing mitral valve repair for severe primary MR. Methods and Results: Echocardiography was performed prior to mitral valve surgery in 566 patients (age 64 ± 12years, 66% men) with severe primary MR. The study population was subdivided based on a LARS value of 22%, using a spline curve analysis. The primary endpoint was all-cause mortality. During a median follow-up of 7 (4-12) years, 129 (22.8%) patients died. Patients with LARS ≤22% showed significantly higher mortality rates at 1-, 3-, and 5-year follow-up (6%, 12%, and 15%, respectively) when compared with patients with LARS >22% (2%, 3% and 5%, respectively, P < 0.001). Age [hazard ratio (HR): 1.06; 95% confidence interval (CI): 1.03-1.09; P < 0.001], LV global longitudinal strain (HR: 0.92; 95% CI: 0.87-0.98; P = 0.014), and LARS (HR: 0.96; 95% CI: 0.93-0.99; P = 0.014) were independently associated with all-cause mortality. Conclusion: Preoperative LARS is independently associated with all-cause mortality in patients undergoing mitral valve repair for primary MR and provides incremental prognostic value over LA volume. LARS might be helpful to guide timing of mitral valve surgery in patients with severe primary MR. Competing Interests: Conflict of interest: The Department of Cardiology of the Leiden University Medical Centre received unrestricted research grants from Abbott Vascular, Bayer, Biotronik, Bioventrix, Boston Scientific, Edwards Lifesciences, GE Healthcare, Ionnis, and Medtronic. J.J.B. received speaker fees from Abbott Vascular. N.A.M. received speaker fees from Abbott Vascular and GE Healthcare. V.D. received speaker fees from Abbott Vascular, Edwards Lifesciences, MSD, Novartis, and GE Healthcare. The remaining authors have nothing to disclose. (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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