1b127a411d21fe921329c5c078729fa4 pmc_10298909.pdf da9baa64fbbf17a639b080dd25f19356f181c923 pmc_10298909.pdf a79a2ebbb997ecfd6c8b4ef402d37b6386eae37db610b40787ce3db65bf29455 pmc_10298909.pdf Title: Global Longitudinal Strain Predicts Outcomes in Patients with Reduced Left Ventricular Function Undergoing Transcatheter Edge-to-Edge Mitral Repair Subject: Background: The timing and selection of optimal candidates for mitral transcatheter edge-to-edge valve repair remains to be fully determined, especially in cases with severely depressed left ventricular ejection fraction (LVEF). The objective of this study is to evaluate the prognostic value of myocardial strain (LVGLS) in this setting. Methods: Retrospectively, 172 consecutive patients with LVEF 40% and severe MR treated with MitraClip were included. Four groups were generated according to the LVEF (<30% or 30%) and median LVGLS. The primary end-point was cardiovascular mortality. Results: Procedural success was high (96.5%) and complications were rare. At one-year follow-up, 82.5% of patients maintained MR grade 2, 79.2% were at a NYHA class II and a reduction of 80% in heart failure admissions was observed in all groups. Interestingly, among patients with a more depressed LVEF, LVGLS was found to be an independent predictor for cardiovascular mortality (HR: 3.3; 95% CI: 1.1–10, p = 0.023). Conclusions: Mitral valve repair with MitraClip is safe and it improves the mid-term functional class of patients regardless of LVEF. LVGLS can help in the selection of optimal candidates and timing for this procedure, as well as in the recognition of those patients with worse prognoses. Keywords: Mitral regurgitation; left ventricular global longitudinal strain; MitraClip Author: Estefania Fernandez-Peregrina, Luis Asmarats, Rodrigo Estevez-Loureiro, Isaac Pascual, Diana Bastidas, Tomas Benito-González, Berenice Caneiro-Queija, Pablo Avanzas, Jose Alberto De Agustin, Felipe Fernández-Vazquez, Manuel Barreiro-Pérez, Victor Leon, Luis Nombela-Franco, Carmen Garrote, Chi-Hion Li, José Antonio Baz, Antonio Adeba, Jordi Sans-Roselló, Javier Gualis and Dabit Arzamendi Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Jun 27 07:52:54 2023 CEST ModDate: Tue Jun 27 07:58:33 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1291786 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- TLGRFU+VnURWPalladioL Type 1 Custom yes yes no 10 0 WJHMHJ+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 XGOHUG+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 ZQTVNM+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 KOSUXD+CMSY10 Type 1 Builtin yes yes no 28 0 NXRFTX+CMBSY10 Type 1 Builtin yes yes no 32 0 ZZTQUO+VnURWPalladioL-Bold Type 1 Custom yes yes no 36 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 54 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 57 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 82 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 103 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 107 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 111 0 BCDHEE+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 115 0 BCDIEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 122 0 BCDJEE+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 128 0 BCDKEE+PalatinoLinotype-BoldItalic TrueType WinAnsi yes yes no 134 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 143 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 147 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 151 0 BCDIEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 155 0 BCDJEE+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 161 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 177 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 181 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 185 0 BCDIEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 189 0 BCDJEE+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 195 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-04-11 02:38:42 CEST RepresentationInformation: pmc_10298909.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-03-15 02:38:06 CET Size: 1291786 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 330 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Item: Title: Results Destination: section.3 Children: Item: Title: Baseline Results Destination: subsection.3.1 Item: Title: Procedural Results Destination: subsection.3.2 Item: Title: Follow-Up Results Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.A. Info: Title: Global Longitudinal Strain Predicts Outcomes in Patients with Reduced Left Ventricular Function Undergoing Transcatheter Edge-to-Edge Mitral Repair Author: Estefania Fernandez-Peregrina, Luis Asmarats, Rodrigo Estevez-Loureiro, Isaac Pascual, Diana Bastidas, Tomas Benito-González, Berenice Caneiro-Queija, Pablo Avanzas, Jose Alberto De Agustin, Felipe Fernández-Vazquez, Manuel Barreiro-Pérez, Victor Leon, Luis Nombela-Franco, Carmen Garrote, Chi-Hion Li, José Antonio Baz, Antonio Adeba, Jordi Sans-Roselló, Javier Gualis and Dabit Arzamendi Subject: Background: The timing and selection of optimal candidates for mitral transcatheter edge-to-edge valve repair remains to be fully determined, especially in cases with severely depressed left ventricular ejection fraction (LVEF). The objective of this study is to evaluate the prognostic value of myocardial strain (LVGLS) in this setting. Methods: Retrospectively, 172 consecutive patients with LVEF 40% and severe MR treated with MitraClip were included. Four groups were generated according to the LVEF (<30% or 30%) and median LVGLS. The primary end-point was cardiovascular mortality. Results: Procedural success was high (96.5%) and complications were rare. At one-year follow-up, 82.5% of patients maintained MR grade 2, 79.2% were at a NYHA class II and a reduction of 80% in heart failure admissions was observed in all groups. Interestingly, among patients with a more depressed LVEF, LVGLS was found to be an independent predictor for cardiovascular mortality (HR: 3.3; 95% CI: 1.1 10, p = 0.023). Conclusions: Mitral valve repair with MitraClip is safe and it improves the mid-term functional class of patients regardless of LVEF. LVGLS can help in the selection of optimal candidates and timing for this procedure, as well as in the recognition of those patients with worse prognoses. 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