Valvular & structural heart disease
Integrated Atrial and Ventricular Strain Assessment in Patients With Severe Degenerative Mitral Regurgitation Undergoing Surgery
Authors' conclusion
Concomitant impairment of both PALS and LV-GLS identified patients at the highest mortality risk.
Study context
- Population
- Patients with severe degenerative mitral regurgitation (MR) undergoing valve repair or replacementexternal validation 605
- Participants
- 1,314 patients
- Exposure
- Impaired vs preserved peak atrial longitudinal strain (PALS) and LV-GLS
- Outcome
- All-cause mortality
- Follow-up
- Median , 8.4 years
Methodological detailsderivation cohort, external validation cohort
- Derivation cohort
- External validation cohort
Main finding
As reported in the abstract
All-cause mortality
- Impaired PALS
- aHR 2.11; P < 0.001
- Impaired LV-GLS
- aHR 1.66; P = 0.008
- Both impaired · worst outcome
- aHR 2.50; P < 0.001
Observational data: associations, not effects.
Further findings
Combined strain vs traditional left ventricular (LV) dysfunction criteria (LVEF ≤60% or LV end-systolic dimension ≥40 mm), asymptomatic patients (subgroup)
- Net reclassification index
- 0.436 (P < 0.001)
- Integrated discrimination improvement
- 0.024 (P = 0.003)
- Asymptomatic n = 900
Prognostic contribution of each strain parameter (subgroups)
- Varied by the functional status of the other chamber
External validation
- Confirmed these associations
Original publication
Integrated Atrial and Ventricular Strain Assessment in Patients With Severe Degenerative Mitral Regurgitation Undergoing Surgery. JACC Cardiovasc Imaging. Published 30 January 2026. doi:10.
Summarised from the published abstract; every number is checked against it