Our Summary

This study looks at how we can better predict which patients with heart failure, specifically those with a condition called secondary mitral regurgitation (SMR), will benefit from a certain type of heart valve repair. The researchers focused on two measures of heart function, known as left ventricular global longitudinal strain (LV-GLS) and reservoir left atrial longitudinal strain (LASr).

The study involved 110 patients with SMR who had undergone a minimally invasive heart valve repair procedure. Over roughly 8 years, 58% of these patients died. The researchers found significant improvements in heart function in a portion of these patients.

The results showed that LV-GLS and LASr were good indicators of overall survival rates, but traditional measures like the left ventricular ejection fraction and left atrial volume index were not. In fact, LV-GLS was the only predictor of improved heart function after the repair procedure. For patients with irregular heart rhythms (atrial fibrillation), LASr was the only predictor of improved heart function.

In simpler terms, these findings suggest that these two measures, LV-GLS and LASr, could help doctors identify which patients with SMR are most likely to benefit from this type of heart valve repair.

FAQs

  1. What is secondary mitral regurgitation (SMR) and how is it related to heart failure?
  2. What are LV-GLS and LASr and how do they help in predicting the success of heart valve repair in patients with SMR?
  3. What traditional measures were found to be ineffective in predicting the success of the heart valve repair in the study?

Doctor’s Tip

A doctor might tell a patient that by monitoring their LV-GLS and LASr levels, they can better assess the success of their mitral valve repair procedure and overall heart function. This information can help guide treatment decisions and improve outcomes for patients with SMR. It is important for patients to follow up with their doctor regularly and discuss any changes in their heart function to ensure they are receiving the most effective care.

Suitable For

Patients who are typically recommended mitral valve repair are those with secondary mitral regurgitation (SMR) and heart failure. In particular, patients with irregular heart rhythms (atrial fibrillation) may benefit from this type of procedure. The study suggests that using measures like left ventricular global longitudinal strain (LV-GLS) and reservoir left atrial longitudinal strain (LASr) can help doctors predict which patients are most likely to benefit from mitral valve repair.

Timeline

Before mitral valve repair:

  1. Patient is diagnosed with secondary mitral regurgitation (SMR), a condition where the mitral valve does not close properly, causing blood to flow backwards in the heart.
  2. Patient undergoes various tests and evaluations to determine the severity of their SMR and whether they are a candidate for mitral valve repair.
  3. Once deemed a candidate, patient undergoes minimally invasive heart valve repair procedure.

After mitral valve repair:

  1. Following the procedure, patient is monitored closely for complications and recovery progress.
  2. Over the course of roughly 8 years, patient’s heart function is evaluated using measures such as left ventricular global longitudinal strain (LV-GLS) and reservoir left atrial longitudinal strain (LASr).
  3. Researchers find that improvements in heart function are seen in a portion of patients, with LV-GLS being a strong predictor of overall survival rates and improved heart function post-repair.
  4. Patients with irregular heart rhythms (atrial fibrillation) show improvements in heart function based on LASr measurements.
  5. These findings suggest that LV-GLS and LASr could be valuable indicators for doctors in identifying which patients with SMR are most likely to benefit from mitral valve repair.

What to Ask Your Doctor

Some questions a patient should ask their doctor about mitral valve repair may include:

  1. What is the purpose of the mitral valve repair procedure?
  2. Am I a suitable candidate for minimally invasive heart valve repair?
  3. How will LV-GLS and LASr be measured and what do these measures indicate about my heart function?
  4. How will the results of these measures impact my treatment plan and overall prognosis?
  5. What are the potential risks and complications associated with mitral valve repair?
  6. What is the expected recovery time and rehabilitation process after the procedure?
  7. How often will I need follow-up appointments and monitoring after the mitral valve repair?
  8. Are there any lifestyle changes or medications I should consider post-procedure to optimize my heart health?
  9. How will the mitral valve repair impact my overall quality of life and ability to perform daily activities?
  10. Are there any alternative treatment options for mitral valve repair that I should be aware of?

Reference

Authors: Kotrc M, Bartunek J, Benes J, Beles M, Vanderheyden M, Casselman F, Ondrus T, Mo Y, Praet FV, Penicka M. Journal: ESC Heart Fail. 2022 Aug;9(4):2686-2694. doi: 10.1002/ehf2.14001. Epub 2022 Jun 6. PMID: 35670015