医学
心脏病学
内科学
危险系数
二尖瓣反流
二尖瓣修补术
二尖瓣
置信区间
临床终点
随机对照试验
作者
Jan Stassen,Aniek L. van Wijngaarden,Steele C Butcher,Meindert Palmen,Lieven Herbots,Jeroen J. Bax,Victoria Delgado,Nina Ajmone Marsan
出处
期刊:European Journal of Echocardiography
[Oxford University Press]
日期:2022-03-18
卷期号:24 (1): 142-151
被引量:8
标识
DOI:10.1093/ehjci/jeac058
摘要
Abstract 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.
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