Predictive Value of Global Longitudinal Strain in a Surgical Population of Organic Mitral Regurgitation

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.)