Intraoperative global longitudinal strain and strain rate as predictors of unfavorable outcome following…

Cohort studyJournal of anesthesia, analgesia and critical care· Oct 2025

Intraoperative global longitudinal strain and strain rate as predictors of unfavorable outcome following on-pump mitral surgery: a prospective observational study.

Fabrizio Monaco, Alessandra Bonaccorso, Jacopo D'Andria Ursoleo … Mit-Go Study Group Collaborators

Cardiac & Thoracic AnesthesiaCohort studyQ1IF 3.7

Higher intraoperative strain predicted much greater odds of low cardiac output syndrome

Intraoperative global longitudinal strain and strain rate as predictors of unfavorable outcome following on-pump mitral surgery: a prospective observational study.

Fabrizio Monaco … Mit-Go Study Group Collaborators

Journal of anesthesia, analgesia and critical care · Oct 2025 · Q1 in Anesthesiology

Background

Low cardiac output syndrome (low cardiac output syndrome) is a life-threatening complication following cardiac surgery.

Methods

A trained anesthesiologist performed standard transesophageal echocardiography after general anesthesia induction and before establishment of cardiopulmonary bypass.

n = 126 patients

Results

abnormal strain nearly 5.5 times the odds of low cardiac output syndrome

odds ratio 5.48 (95% CI 1.63 to 18.50)

CI excludes the null - significant

More results

In 126 included patients, low cardiac output syndrome occurred in 31 (25%) instances.

Optimal cut-offs to predict low cardiac output syndrome were > - 19.1% for global longitudinal strain (area under the curve [AUC], 0.79; P < 0.001) and ≤ - 0.98 s -1 for strain rate (AUC, 0.66; P = 0.01).

More results

Predictors for low cardiac output syndrome were global longitudinal strain > - 19.1%, tricuspid annular plane systolic excursion (tricuspid annular plane systolic excursion), ejection fraction (ejection fraction), and creatinine clearance (clearance).

“

Conclusion · 1 of 2

We found that global longitudinal strain, tricuspid annular plane systolic excursion, ejection fraction, and clearance were independent predictors of postoperative low cardiac output syndrome in patients undergoing mitral surgery.

Conclusion · 2 of 2

Among them, a global longitudinal strain value > - 19.1% was associated with higher odds of low cardiac output syndrome. CLINICAL TRIAL NUMBER: ClinicalTrials.gov, NCT04045340, date of registration: 02.08.2019.

Intraoperative global longitudinal strain and strain rate as predictors of unfavorable outcome following on-pump mitral surgery: a prospective observational study.

Intraoperative global longitudinal strain and strain rate as predictors of unfavorable outcome following on-pump mitral surgery: a prospective observational study.

Related papers