Global longitudinal strain to determine optimal timing for surgery in primary mitral regurgitation: A systematic review

Background Primary mitral regurgitation (PMR) results in adverse remodeling changes and left ventricular (LV) dysfunction. Assessing LV function has prognostic value predicting morbidity mortality. Indications for surgery include parameters such as ejection fraction (LVEF) systolic dimensions. Current guidelines are limited identifying patients at optimal time surgery. Impaired postoperative LVEF indicates poor outcomes subsequent heart failure. Global longitudinal strain (GLS) via speckle tracking echocardiography (STE) presents a promising parameter to detect subclinical dysfunction asymptomatic patients. Methods Following PRISMA guidelines, literature search was conducted with Cochrane Library, PudMed, SCOPUS, Web of Science. Key MeSH terms included “mitral regurgitation,” valve insufficiency,” “global strain,” “deformation,” “LV-GLS,” “GLS.” Inclusion criteria (1) severe PMR, (2) mixed population symptomatic patients, (3) standardized methods assessing using 2D-STE, (4) repair or replacement surgery, (5) patient measured after Search returned 234 papers, 12 which met the inclusion were subsequently reviewed. Results Baseline GLS is an independent predictor outcomes, ranging from ?17.9 ?21.7% GLS. A significant negative correlation observed between preoperative LVEF. baseline associated higher mortality rates. Better long-term survival rates seen who underwent early Conclusion shows sensitivity outcomes. Further analysis required determine threshold identify