000			03869nam a22005417a 4500
008			210607s20212021 xxu||||| |||| 00| 0 eng d
022			_a0894-7317
024			_a10.1016/j.echo.2021.04.003 [doi]
024			_aS0894-7317(21)00184-X [pii]
040			_aOvid MEDLINE(R)
099			_a33845158
245			_aLeft Ventricular Global Longitudinal Strain as a Predictor of Outcomes in Patients with Heart Failure with Secondary Mitral Regurgitation: The COAPT Trial.
251			_aJournal of the American Society of Echocardiography. 34(9):955-965, 2021 09.
252			_aJ Am Soc Echocardiogr. 34(9):955-965, 2021 09.
252			_zJ Am Soc Echocardiogr. 2021 Apr 09
253			_aJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
260			_c2021
260			_fFY2022
265			_saheadofprint
265			_sppublish
266			_d2021-06-07
268			_aJournal of the American Society of Echocardiography. 2021 Apr 09
269			_fFY2021
520			_aBACKGROUND: Left ventricular (LV) global longitudinal strain (GLS) is a sensitive marker of LV function and may help identify patients with heart failure (HF) and secondary mitral regurgitation (SMR) who would have a better prognosis and are more likely to benefit from edge-to-edge transcatheter mitral valve repair (TMVr) with the MitraClip. We sought to assess the prognostic utility of baseline LVGLS during 2-year follow-up of HF patients with SMR enrolled in the COAPT trial.
520			_aCONCLUSIONS: Baseline LVGLS did not predict death or HFH throughout 2-year follow-up, but it did predict outcomes after 10 months. The benefit of TMVr over GDMT alone was consistent in all sub-groups irrespective of baseline LVGLS. Copyright (c) 2021. Published by Elsevier Inc.
520			_aMETHODS: Symptomatic HF patients with moderate-to-severe or severe SMR who remained symptomatic despite maximally-tolerated guideline directed medical therapy (GDMT) were randomized to TMVr plus GDMT or GDMT alone. Speckle tracking-derived LVGLS from baseline echocardiograms was obtained in 565 patients and categorized by tertiles. Death and HF hospitalization (HFH) at 2-year follow-up were the principal outcomes of interest.
520			_aRESULTS: Patients with better baseline LVGLS had higher blood pressure, greater LV ejection fraction and stroke volume, lower levels of B-type natriuretic peptide and smaller LV size. No significant difference in outcomes at 2-year follow-up were noted according to LVGLS. However, the rate of death or HFH between 10 and 24 months was lower in patients with better LVGLS (p=0.03), with no differences before 10 months. There was no interaction between GLS tertiles and treatment group with respect to 2-year clinical outcomes.
546			_aEnglish
650			_a*Heart Failure
650			_a*Mitral Valve Insufficiency
650			_aHeart Failure/co [Complications]
650			_aHeart Failure/dg [Diagnostic Imaging]
650			_aHumans
650			_aMitral Valve Insufficiency/dg [Diagnostic Imaging]
650			_aMitral Valve Insufficiency/di [Diagnosis]
650			_aStroke Volume
650			_aTreatment Outcome
650			_aVentricular Function, Left
651			_aMedStar Health Research Institute
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
700			_aAsch, Federico M
700			_aMedvedofsky, Diego
700			_aWeissman, Neil J
790			_aAbraham WT, Alu MC, Asch FM, Bax JJ, COAPT Investigators, Delgado V, Grayburn PA, Kapadia SR, Kar S, Lerakis S, Lim DS, Lindenfeld J, Liu M, Mack MJ, Medvedofsky D, Namazi F, Pio SM, Stone GW, Weissman NJ, Zhou Z
856			_uhttps://dx.doi.org/10.1016/j.echo.2021.04.003 _zhttps://dx.doi.org/10.1016/j.echo.2021.04.003
942			_cART _dArticle
999			_c6319 _d6319