Prognostic Value of Speckle-tracking Echocardiography in Assessing Outcomes of Transcatheter Edge-to-edge Repair for Mitral Regurgitation

斑点追踪超声心动图在评估经导管缘对缘修复二尖瓣反流术后疗效中的预后价值

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Abstract

Mitral regurgitation (MR) is a valvular heart disease with high morbidity and mortality. Transcatheter edge-to-edge repair (TEER) presents a viable treatment option for severe MR in high-risk surgical patients. This review aims to assess the prognostic significance of speckle-tracking echocardiography (STE) in predicting outcomes after TEER and its potential role in patient management. A systematic literature review was done on PubMed for studies until November 2024. The search incorporated keywords of STE and TEER, including original research on STE's predictive value in TEER patients. Studies concerning surgical mitral valve repair or unrelated imaging techniques were excluded. Twenty-nine articles were included, indicating that STE metrics, especially global longitudinal strain (GLS), correlate with clinical outcomes like heart failure progression and mortality. Baseline GLS was determined as predictive of hospitalization and mortality, while post-TEER GLS improvements were associated with better functional capacity. Furthermore, left atrial function metrics were significant in predicting arrhythmia recurrence. This study highlights the utility of STE in predicting outcomes for TEER patients. While findings are encouraging, additional research is essential to elucidate the long-term effects of TEER on cardiac function, thereby enhancing patient selection and management approaches. This review highlights the relevance of STE in prognosticating outcomes for patients undergoing TEER. Further investigations are essential to clarify the long-term repercussions of TEER on cardiac functionality, thereby refining patient selection and management strategies.

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