Valvular & structural heart disease
Prognostic value of right ventricular longitudinal strain in patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge mitral valve repair
Authors' conclusion
RVLS is a useful and reliable tool to identify patients with SMR undergoing TEER at high risk of mortality and HF hospitalization, on top of other clinical and echocardiographic parameters, with RVFWLS offering the best prognostic performance.
Study context
- Population
- Patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge repair (TEER)45 reached endpoint
- Participants
- 142 patients
- Exposure
- RV longitudinal strain vs conventional echocardiographic parameters of RV function
- Outcome
- Composite of:
- All-cause death
- HF hospitalization
- Follow-up
- 1 year
Methodological detailstwo Italian centres
- Two Italian centres
Main finding
As reported in the abstract
Prediction of all-cause death or HF hospitalization
| Group | Cut-off | Sensitivity | Specificity | AUC | P |
|---|---|---|---|---|---|
| RV free-wall longitudinal strain (RVFWLS) | −18% | 72% | 71% | 0.78 | P < 0.001 |
| RV global longitudinal strain (RVGLS) | −15% | 56% | 76% | 0.69 | P < 0.001 |
Cut-off
RV free-wall longitudinal strain (RVFWLS)−18%
RV global longitudinal strain (RVGLS)−15%
Sensitivity
RV free-wall longitudinal strain (RVFWLS)72%
RV global longitudinal strain (RVGLS)56%
Specificity
RV free-wall longitudinal strain (RVFWLS)71%
RV global longitudinal strain (RVGLS)76%
AUC
RV free-wall longitudinal strain (RVFWLS)0.78
RV global longitudinal strain (RVGLS)0.69
P
RV free-wall longitudinal strain (RVFWLS)P < 0.001
RV global longitudinal strain (RVGLS)P < 0.001
Observational data: associations, not effects.
Further findings
RVFWLS ≥ −18% vs RVFWLS < −18%
Cumulative event-free survival by RVFWLS cut-off
< 0.001
RVGLS ≥ −15% vs RVGLS < −15%
Cumulative event-free survival by RVGLS cut-off
P < 0.001
Multivariable analysis
- Fractional area change (FAC), RVGLS and RVFWLS independent predictors of events; RVFWLS and RVGLS cut-offs independently associated with outcomes
Original publication
Prognostic value of right ventricular longitudinal strain in patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge mitral valve repair. Eur Heart J Cardiovasc Imaging. Published 17 May 2023. doi:10.
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