{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T15:28:50Z","timestamp":1793114930216,"version":"4.5.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,9,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Left ventricular (LV) global longitudinal strain (GLS) provides incremental prognostic information over LV ejection fraction in patients with heart failure (HF) and secondary mitral regurgitation. We examined the prognostic impact of LV GLS improvement in this population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation) trial randomized symptomatic patients with HF with severe (3+\/4+) mitral regurgitation to transcatheter edge\u2010to\u2010edge repair with the MitraClip device plus maximally tolerated guideline\u2010directed medical therapy (GDMT) versus GDMT alone. LV GLS was measured at baseline and 6\u2010month follow\u2010up. The relationship between the improvement in LV GLS from baseline to 6\u2009months and the composite of all\u2010cause death or HF hospitalization between 6\u2010 and 24\u2010month follow\u2010up were assessed. Among 383 patients, 174 (45.4%) had improved LV GLS at 6\u2010month follow\u2010up (83\/195 [42.6%] with transcatheter edge\u2010to\u2010edge repair+GDMT and 91\/188 [48.4%] with GDMT alone;\n              <jats:italic>P<\/jats:italic>\n              =0.25). Improvement in LV GLS was strongly associated with reduced death or HF hospitalization between 6 and 24\u2009months (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.009), with similar risk reduction in both treatment arms (\n              <jats:italic>P<\/jats:italic>\n              <jats:sub>interaction<\/jats:sub>\n              =0.40). By multivariable analysis, LV GLS improvement at 6\u2009months was independently associated with a lower risk of death or HF hospitalization (hazard ratio [HR], 0.55 [95% CI, 0.36\u20130.83];\n              <jats:italic>P<\/jats:italic>\n              =0.009), death (HR, 0.48 [95% CI, 0.29\u20130.81];\n              <jats:italic>P<\/jats:italic>\n              =0.006), and HF hospitalization (HR, 0.50 [95% CI, 0.31\u20130.81];\n              <jats:italic>P<\/jats:italic>\n              =0.005) between 6 and 24\u2009months.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Among patients with HF and severe mitral regurgitation in the COAPT trial, improvement in LV GLS at 6\u2010month follow\u2010up was associated with improved outcomes after both transcatheter edge\u2010to\u2010edge repair and GDMT alone between 6 and 24\u2009months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT01626079.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.029956","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T09:28:11Z","timestamp":1693387691000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Changes in Left Ventricular Global Longitudinal Strain in Patients With Heart Failure and Secondary Mitral Regurgitation: The COAPT Trial"],"prefix":"10.1161","volume":"12","author":[{"given":"Stephan M.","family":"Pio","sequence":"first","affiliation":[{"name":"Department of Cardiology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Medvedofsky","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9745-5498","authenticated-orcid":false,"given":"Jan","family":"Stassen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Leiden University Medical Center Leiden the Netherlands"},{"name":"Department of Cardiology Jessa Hospital Hasselt Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9841-2737","authenticated-orcid":false,"given":"Victoria","family":"Delgado","sequence":"additional","affiliation":[{"name":"Department of Cardiology Leiden University Medical Center Leiden the Netherlands"},{"name":"Hospital University Germans Trias i Pujol Badalona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farnaz","family":"Namazi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil J.","family":"Weissman","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Grayburn","sequence":"additional","affiliation":[{"name":"Baylor Scott &amp; White Health Plano TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1547-4869","authenticated-orcid":false,"given":"Saibal","family":"Kar","sequence":"additional","affiliation":[{"name":"Los Robles Regional Medical Center Thousand Oaks CA"},{"name":"Bakersfield Heart Hospital Bakersfield CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Scott","family":"Lim","sequence":"additional","affiliation":[{"name":"University of Virginia Charlottesville VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhipeng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0430-3020","authenticated-orcid":false,"given":"Maria C.","family":"Alu","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4155-4451","authenticated-orcid":false,"given":"Bj\u00f6rn","family":"Redfors","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation New York NY"},{"name":"Department of Cardiology Sahlgrenska University Hospital Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0026-3391","authenticated-orcid":false,"given":"Samir","family":"Kapadia","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9207-3634","authenticated-orcid":false,"given":"JoAnn","family":"Lindenfeld","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center Nashville TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4805-1037","authenticated-orcid":false,"given":"William T.","family":"Abraham","sequence":"additional","affiliation":[{"name":"Ohio State University Medical Center Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3148-9158","authenticated-orcid":false,"given":"Michael J.","family":"Mack","sequence":"additional","affiliation":[{"name":"Baylor Scott &amp; White Health Plano TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1744-5271","authenticated-orcid":false,"given":"Federico M.","family":"Asch","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3416-8210","authenticated-orcid":false,"given":"Gregg W.","family":"Stone","sequence":"additional","affiliation":[{"name":"The Zena and Michael A. 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