Introduction

Non-invasive myocardial work assessment, using global left ventricular longitudinal strain (GLS), has emerged as a key tool for evaluating left ventricular (LV) function independent of loading conditions.

Aim

This study aims to evaluate the effects of concomitant mitral regurgitation (MR) on myocardial work parameters in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI).

Material and methods

A prospective registry study was conducted on 95 consecutive patients with severe AS, 28% of whom had moderate to severe MR. Echocardiographic data, including GLS and myocardial work parameters (global constructive work [GCW], global wasted work [GWW], and global work efficiency [GWE]), were collected prior to TAVI.

Results

While GLS values did not significantly differ between MR severity groups, GCW and GWE showed significant variation. The lowest GCW values were observed in patients with severe MR (1483.3 ±282.7 mm Hg%) and the highest in those with moderate MR (2114.9 ±534.6 mm Hg%) (p = 0.01). Similarly, lower GWE values were observed in patients with severe MR compared to the other groups (p = 0.02). No significant differences were found for GWW (p = 0.21).

Conclusions

The findings suggest that while GLS remains relatively consistent across different MR severity groups, GCW and GWE tend to decrease in patients with severe MR. This observation may indicate that GCW is a more responsive marker of myocardial function in the presence of concomitant MR.