Myocardial work and left heart deformation parameters across primary mitral regurgitation severity

• DOI: 10.1016/j.ijcard.2024.131772
• Publication Date: 2024-01-09T12:11:03Z
• Authors: Maria Concetta Pa...; Francesca Vannuccini; Giulia Elena Mandoli; Matteo Lisi; Maria Alma Iuliano; Alfonso Santoro; Francesco Paolo N...; Enrico Emilio Div...; Veronica Lorenz; Gianfranco Montesi; Luna Cavigli; Marta Focardi; Flavio D'Ascenzi; Matteo Cameli
• Keywords: Speckle tracking echocardiography

AimsMyocardial work (MW) estimation by pressure-strain loops using speckle tracking echocardiography (STE) has shown to evaluate left ventricular (LV) contraction overcoming the load-dependency limit of LV global longitudinal strain (GLS). This proved useful hemodynamic variation settings e.g. heart failure and valvular disease. However, MW parameters across different stages primary mitral regurgitation (MR) its impact on symptoms, which was aim our study, never been investigated.Methods resultsConsecutive patients with mild, moderate severe MR were prospectively enrolled. Exclusion criteria were: chronic atrial fibrillation, prosthesis, previous cardiac surgery.Clinical evaluation, blood sample tests, ECG STE measurement performed. Patients then divided into groups according severity. Differences among predictors symptoms (as NYHA class≥2) explored as study endpoints.Overall, 180 enrolled (60 mild,60 moderate,60 MR). GLS peak (PALS) reduced Global constructive (GCW) wasted (GWW) significantly improved, while efficiency (GWE) reduced, in MR. Among echocardiographic parameters, PALS emerged best predictor class (p < 0.001;area under curve,AUC = 0.7).ConclusionsMW accurately describe pathophysiology MR, initial attempt increased contractility compensate volume overload parallel disease progress, although low efficacy, is most associated burden symptoms.