Prognostic Value of the Global Left Ventricular Contractility Index in Patients with Severe Mitral Regurgitation and Preserved Left Ventricular Ejection Fraction
Introduction: Assessment of left ventricular (LV) systolic function is important in valvular heart disease. The global LV contractility index, <i>dσ*/dt<sub>max</sub></i>, is load-independent and has been reported to be associated with clinical outcomes in heart failure and a...
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Main Authors: | , , , , , , , , , , , , , |
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Format: | Article |
Language: | English |
Published: |
MDPI AG
2025-06-01
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Series: | Journal of Cardiovascular Development and Disease |
Subjects: | |
Online Access: | https://www.mdpi.com/2308-3425/12/6/227 |
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Summary: | Introduction: Assessment of left ventricular (LV) systolic function is important in valvular heart disease. The global LV contractility index, <i>dσ*/dt<sub>max</sub></i>, is load-independent and has been reported to be associated with clinical outcomes in heart failure and aortic stenosis. We aim to assess if <i>dσ*/dt<sub>max</sub></i> could predict adverse outcomes in patients with severe mitral regurgitation (MR). Methodology: We studied <i>dσ*/dt<sub>max</sub></i> in a cohort of 127 patients with isolated severe primary MR and preserved LVEF ≥ 60%. Patients with prior valvular intervention or concurrent valvular disease were excluded. We tested <i>dσ*/dt<sub>max</sub></i> against a composite of adverse outcomes including all-cause mortality, heart failure hospitalization, and mitral valve intervention. Results: The cohort had a mean age of 58 years old and was predominantly male. Of the 127 patients, eight (6.3%) needed subsequent hospitalization for heart failure, while 30 (23.6%) and 11 (8.7%) patients underwent mitral valve repair and replacement, respectively, And 14 (11.0%) passed away. Of the patients (<i>n</i> = 54 (42.5%)) who had an adverse outcome during follow-up, <i>dσ*/dt<sub>max</sub></i> demonstrated an independent association with composite adverse outcome, including its individual components. On ROC analysis, a cut-off of 2.15 s<sup>−1</sup> was identified. Based on this cut-off, <i>dσ*/dt<sub>max</sub></i> retained an independent association with composite adverse outcome after adjusting for covariates including age, sex, ischemic heart disease, pulmonary artery systolic pressure, and left ventricular end systolic diameter. Conclusions: In patients with severe primary MR and preserved LVEF, reduced <i>dσ*/dt<sub>max</sub></i> was an independent predictor of adverse outcomes. It can be a useful addition to the armamentarium for assessing patients with severe MR. |
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ISSN: | 2308-3425 |