Predictive Value of Global Longitudinal Strain in a Surgical Population of Organic Mitral Regurgitation
Predictive Value of Global Longitudinal Strain in a Surgical Population of Organic Mitral Regurgitation
复制标题
DOI：
10.1016/j.echo.2012.04.009
复制
发表时间：
2012-07-01
影响因子：
6.5
通讯作者：
Donal, Erwan
中科院分区：
文献类型：
--
作者：
Mascle, Sophie;Schnell, Frederic;Donal, Erwan
背景：由于缺乏可靠的超声心动图参数来预测手术后的恢复，严重二尖瓣反流的最佳手术时机仍然存在争议。本研究的目的是确定术前记录的全局纵向应变（GLS）是否有助于预测术后左室射血分数（LVEF）。方法：本研究前瞻性纳入88例严重退行性二尖瓣反流患者（平均年龄63±13岁，男性59例）。在二尖瓣手术前和手术后6 +/- 1个月进行休息超声心动图检查。患者分为两组：A组（术后LVEF < 50%）和B组（术后LVEF < 50%）。结果：B组患者术前左室收缩末期直径增大（21.6 +/- 2.6 vs 19.2 +/- 3.7 mm/m, P = 0.02），术前GLS受损（-17 +/- 2.8% vs -19.6 +/- 3.6%, P = 0.01），而术前LVEF无差异。术前左室收缩末期直径> 22 mm/m(2)和GLS < -18%是术后左室功能障碍的独立预测因子。结论：左室收缩末期直径是一个公认的预后指标。此外，本研究还证明了术前GLS对预测术后左室功能障碍的附加和独立预测价值。[J] .中华医学会心脏科杂志，2012;25:766-72.]
Background: Because of the lack of reliable echocardiographic parameters to predict recovery after surgery, the optimal timing of surgery for severe mitral regurgitation remains controversial. The aim of this study was to determine whether global longitudinal strain (GLS) recorded preoperatively could help in predicting left ventricular (LV) ejection fraction (LVEF) postoperatively.Methods: A total of 88 patients (mean age, 63 +/- 13 years; 59 men) with severe degenerative mitral regurgitation were included prospectively in this study. Rest echocardiography was performed before and 6 +/- 1 months after mitral valve surgery. Patients were divided into two groups: group A (postoperative LVEF > 50%) and group B (postoperative LVEF < 50%).Results: In group B, patients had larger preoperative LV end-systolic diameters (21.6 +/- 2.6 vs 19.2 +/- 3.7 mm/m(2), P = .02) and impaired preoperative GLS (-17 +/- 2.8% vs -19.6 +/- 3.6%, P = .01), whereas there was no difference in preoperative LVEF. Preoperative LV end-systolic diameter > 22 mm/m(2) and GLS < -18% were independent predictors of postoperative LV dysfunction.Conclusions: LV end-systolic diameter is a well-recognized prognostic marker. In addition, this study demonstrates the additive and independent predictive value of preoperative GLS for predicting postoperative LV dysfunction. (J Am Soc Echocardiogr 2012;25:766-72.)