The Role of Global Longitudinal Strain in Predicting Left Ventricular Reverse Remodeling After Mitral Valve Replacement Surgery in Patients With Primary Mitral Regurgitation

Abstract

Objectives This study aimed to identify the utility of global longitudinal strain (GLS) as a reliable parameter that can accurately forecast left ventricle reverse remodeling (LVRR) in patients undergoing valve replacement surgery for severe chronic primary mitral regurgitation (MR), thereby aiding in assessing mortality and morbidity risk.
Methods This retrospective observational study involved severe primary MR patients who underwent valve replacement surgery between 2018 and 2023. Pre‐ and postsurgery echocardiography data were collected, with GLS measurements utilized to assess left ventricular function. Various echocardiography parameters, including MR severity and LV dimensions, were analyzed. Bivariate and multivariate analyses were performed to explore relationships between GLS and LVRR.
Results This study enrolled 103 patients (54.4% male; mean age 45.4 ± 13.6 years). Statistical analyses revealed GLS to be an independent predictor of LVRR, with a threshold of −16.25% showing 89% sensitivity and 50% specificity. Each 1% increase in GLS corresponded to a 1.14‐fold (odds ratio [OR]: 1.14; 95% confidence interval [CI]: 1.01–1.31; p < 0.05) increased likelihood of LVRR.
Conclusion These findings highlight GLS's potential as a prognostic marker for postsurgical outcomes in severe MR patients.

Keywords: echocardiography; global longitudinal strain; mitral valve insufficiency; ventricular remodeling.

Abbreviations

• AF
  atrial fibrillation
• AML
  anterior mitral leaflet
• AUC
  area under the curve
• CI
  confidence interval
• EF
  ejection fraction
• FS
  fractional shortening
• GLS
  global longitudinal strain
• HR
  heart rate
• IVSD
  interventricular septal dimension
• LAVI
  left atrial volume index
• LV
  left ventricle
• LVEDD
  left ventricle end diastolic dimension
• LVEDV
  left ventricle end diastolic volume
• LVEF
  left ventricle ejection fraction
• LVESD
  left ventricle end systolic dimension
• LVESV
  left ventricle end systolic volume
• LVM
  left ventricle mass
• LVPWD
  left ventricle posterior wall dimension
• LVRR
  left ventricle reverse remodeling
• MR
  mitral regurgitation
• PASP
  pulmonary arterial systolic pressure
• PML
  posterior mitral leaflet
• TAPSE
  tricuspid annular plane systolic excursion