Prognostic Value of left ventricular peak Global Longitudinal Strain after Mitral Valve Surgery in Patients with Primary Severe Mitral Regurge

Hussein, Mohamad Hasan Soliman; Ammar, Ahmed Shafeea; Al-Daydamony, Mohammad Mustafa; Abdel Fattah, Ahmed Mohammed; Mohamed, Mohamed AbdelHady

doi:10.21608/zumj.2025.362324.3850

	Prognostic Value of left ventricular peak Global Longitudinal Strain after Mitral Valve Surgery in Patients with Primary Severe Mitral Regurge
Zagazig University Medical Journal
Article 4, Volume 31, Issue 6, June 2025, Page 2204-2213 PDF (448.45 K)
Document Type: Original Article
DOI: 10.21608/zumj.2025.362324.3850
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Authors
Mohamad Hasan Soliman Hussein¹; Ahmed Shafeea Ammar²; Mohammad Mustafa Al-Daydamony²; Ahmed Mohammed Abdel Fattah ³; Mohamed AbdelHady Mohamed¹
¹Assistant Professor of Cardiology Department, Faculty of Medicine, Zagazig university, Egypt
²Professor of Cardiology Department, Faculty of Medicine, Zagazig university, Egypt
³Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt
Abstract
Background: Assessment of Preclinical systolic dysfunction using global longitudinal strain, a unique and sensitive technique for diagnosing left ventricular dysfuction. This study Aimed to clarify whether left ventricular global longitudinal strain is associated with a favourable clinical outcome after mitral valve (MV) surgery for primary severe mitral regurge (MR) Method: This prospective study included 30 patients with primary severe mitral regurgitation undergoing mitral valve surgery. The patients were classified into three groups according to their ejection fraction: Group I (10 patients with EF 30-45%), Group Ⅱ (10 patients with EF 45-60%), and Group Ⅲ (10 patients with EF >60%). LV-GLS was assessed preoperatively and postoperatively using speckle tracking echocardiography. Patients were monitored for three months after surgery. Results: Mitral valve replacement was done in 70% of Group I, 40% of Group II, and 50% of Group III. In contrast, MV repair was performed in 30%, 60%, and 50% of cases, with no significant difference seen (p=0.391). Echocardiographic results showed comparable patterns, with Group III maintaining superior GLS (-18±1.85), LVEF (67.1±3.6%), and reduced LVEDD and LVESD (p<0.05 for intergroup comparison). Only Group I (20%) experienced post-operative mortality, with no deaths reported in Groups II or III (p=0.12). ROC curve study revealed that GLS had the maximum sensitivity (100%) and specificity (78.26%) at -11.2, with an area under the curve of 0.839. Conclusion: left ventricular GLS is a significant predictor of clinical and echocardiographic outcomes after mitral valve surgery for primary severe mitral regurgitation in early detection of subclinical Left ventricular dysfunction.
Keywords
Mitral regurgitation; Global longitudinal strain; Echocardiography


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