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

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.