[Evaluation of myocardial work in patients with mitral valve prolapse and severe regurgitation: predictive value for prolonged postoperative ICU stay].

MVPSR patients with normal LVEF had significantly lower global myocardial work parameters and higher wasted work compared to non-MVPSR controls.

• MVPSR group (n=80) had lower global work index, global work efficiency (GWE), and global constructive work compared to non-MVPSR group (n=58); all P<0.05
• Global wasted work was higher in the MVPSR group compared to controls (P<0.05)
• Work efficiency and constructive work in basal, intermediate, and apical segments were all lower in MVPSR patients, while wasted work was higher in all segments (all P<0.05)
• Longitudinal strain and work index in the basal segment were both lower in the MVPSR group (P<0.05)
• These findings were observed despite normal LVEF in all MVPSR patients, suggesting subclinical myocardial dysfunction detectable by PSL technology

GWE was an independent predictor of postoperative ICU stay duration in MVPSR patients on multifactor linear regression analysis.

• β = -2.89 (95% CI: -5.43 to -0.34, P = 0.030)
• GWE was negatively correlated with postoperative ICU length of stay
• Analysis was performed using a multifactor linear regression model controlling for other variables
• Mean postoperative ICU stay in the MVPSR group was (37.0 ± 16.8) hours
• Prolonged ICU stay was defined as duration >48 hours

GWE demonstrated good predictive performance for prolonged postoperative ICU stay (>48 hours) by ROC curve analysis.

• Area under the ROC curve for GWE predicting prolonged ICU stay was 0.850 (95% CI: 0.729–0.970)
• Optimal cutoff value for GWE was 92.5%, with GWE ≤92.5% predicting prolonged ICU stay
• Sensitivity at this cutoff was 76.2% and specificity was 82.4%
• ROC curve analysis was applied specifically to evaluate predictive performance for ICU stay >48 hours

The study enrolled 80 MVPSR patients with normal LVEF and 58 non-MVPSR controls matched for gender, age, BMI, and comorbidities.

• MVPSR group: aged (58.9 ± 12.3) years, 61 males; treated at Fuwai Huazhong Cardiovascular Hospital from May 2023 to June 2025
• Non-MVPSR group: 58 subjects including 31 healthy subjects, aged (54.8 ± 15.3) years, 36 males
• All MVPSR patients underwent cardiac valve repair or valve replacement surgery and preoperative echocardiography
• PSL technology was used to assess left ventricular global longitudinal strain, longitudinal strain peak time dispersion, global work index, GWE, global constructive work, global wasted work, and segmental (basal, mid, apical) longitudinal strain and work parameters