Global longitudinal strain is a hallmark of cardiac damage in mitral regurgitation: the Italian arm of the European Registry of mitral regurgitation (EuMiClip)

Table 4 Multivariate associations of LV EF and GLS

Dependent Variable	Covariate	β coefficient	p value
a. in the pooled patients MR
LV EF	LV end-diastolic diameter	− 0.41	<0.0001
	LV end-systolic diameter	−0.54	<0.0001
	LV end-diastolic volume	−0.40	<0.0001
	LV end-systolic volume	−0.71	<0.0001
	LA diameter	−0.25	<0.0001
	LAVi	−0.38	<0.0001
	PASP	−0.18	<0.0001
GLS ^a	LV end-diastolic diameter	−0.40	<0.0001
	LV end-systolic diameter	−0.54	<0.0001
	LV end-diastolic volume	−0.40	<0.0001
	LV end-systolic volume	−0.60	<0.0001
	LA diameter	−0.32	<0.0001
	LAVi	−0.41	<0.0001
	PASP	−0.19	<0.0001
b. In patients with mild MR
LV EF	LV end-diastolic diameter	− 0.24	<0.0001
	LV end-systolic diameter	−0.37	<0.0001
	LV end-diastolic volume	−0.22	<0.0001
	LV end-systolic volume	−0.62	<0.0001
	LA diameter	−0.05	0.417
	LAVi	−0.22	<0.0001
	PASP	−0.02	0.735
GLS ^a	LV end-diastolic diameter	−0.20	<0.0001
	LV end-systolic diameter	−0.35	<0.0001
	LV end-diastolic volume	−0.25	<0.0001
	LV end-systolic volume	−0.45	<0.0001
	LA diameter	−0.13	0.04
	LAVi	−0.23	<0.0001
	PASP	−0.18	=0.003
c. In patients with moderate to severe MR
LV EF	LV end-diastolic diameter	−0.50	<0.0001
	LV end-systolic diameter	−0.59	<0.0001
	LV end-diastolic volume	−0.46	<0.0001
	LV end-systolic volume	−0.72	<0.0001
	LA diameter	−0.21	0.03
	LAVi	−0.27	0.008
	PASP	−0.17	0.09
GLS ^a	LV end-diastolic diameter	−0.47	<0.0001
	LV end-systolic diameter	−0.59	<0.0001
	LV end-diastolic volume	−0.41	<0.0001
	LV end-systolic volume	−0.61	<0.0001
	LA diameter	−0.25	<0.02
	LAVi	−0.29	<0.005
	PASP	−0.30	=0.004

Abbreviations as in Table 4
^aValues of GLS considered as “positive” (sign +) to build the associations in order to strengthen their clinical meaning: the higher values the better strain deformation independent on the plus/minus sign

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