2022
Prognostic value of age-sex adjusted NT-proBNP ratio in obstructive hypertrophic cardiomyopathy
Hutt E, Mentias A, Alashi A, Wadhwa R, Fava A, Lever HM, Thamilarasan M, Popovic ZB, Smedira NG, Desai MY. Prognostic value of age-sex adjusted NT-proBNP ratio in obstructive hypertrophic cardiomyopathy. Progress In Cardiovascular Diseases 2022, 74: 11-18. PMID: 35952727, DOI: 10.1016/j.pcad.2022.08.002.Peer-Reviewed Original ResearchConceptsSeptal reduction therapyBNP ratioNT-proBNP ratioPrimary outcomeAsymptomatic patientsPrognostic valueObstructive hypertrophic cardiomyopathy patientsIncremental prognostic valueNormal NT-proBNPNT-pro BNPObstructive hypertrophic cardiomyopathyLong-term outcomesHypertrophic cardiomyopathy patientsCardiac transplantationNT-proBNPPrimary endpointCardiomyopathy patientsHypertrophic cardiomyopathyReduction therapyHigh riskPatientsDefibrillator dischargeSpline analysisOutcomesBNP
2021
Outcomes in Patients With Obstructive Hypertrophic Cardiomyopathy and Concomitant Aortic Stenosis Undergoing Surgical Myectomy and Aortic Valve Replacement
Desai MY, Alashi A, Popovic ZB, Wierup P, Griffin BP, Thamilarasan M, Johnston D, Svensson LG, Lever HM, Smedira NG. Outcomes in Patients With Obstructive Hypertrophic Cardiomyopathy and Concomitant Aortic Stenosis Undergoing Surgical Myectomy and Aortic Valve Replacement. Journal Of The American Heart Association 2021, 10: e018435. PMID: 34533040, PMCID: PMC8649531, DOI: 10.1161/jaha.120.018435.Peer-Reviewed Original ResearchConceptsObstructive hypertrophic cardiomyopathySevere aortic stenosisAortic valve replacementVentricular outflow tract gradientOutflow tract gradientAortic stenosisHypertrophic cardiomyopathySurgical myectomyValve replacementTract gradientRisk factorsAV areaDynamic left ventricular outflow tract gradientDynamic left ventricular outflow tract obstructionLeft ventricular outflow tract gradientLeft ventricular outflow tract obstructionUS populationRight ventricular systolic pressureSevere obstructive hypertrophic cardiomyopathySudden death risk factorsVentricular outflow tract obstructionMultivariate Cox survival analysisLeft ventricular outflow tractBackground Hypertrophic cardiomyopathyBasal septal thickness
2020
Outcomes in Guideline‐Based Class I Indication Versus Earlier Referral for Surgical Myectomy in Hypertrophic Obstructive Cardiomyopathy
Alashi A, Smedira NG, Hodges K, Popovic ZB, Thamilarasan M, Wierup P, Lever HM, Desai MY. Outcomes in Guideline‐Based Class I Indication Versus Earlier Referral for Surgical Myectomy in Hypertrophic Obstructive Cardiomyopathy. Journal Of The American Heart Association 2020, 10: e016210. PMID: 33342243, PMCID: PMC7955478, DOI: 10.1161/jaha.120.016210.Peer-Reviewed Original ResearchMeSH KeywordsCardiac Surgical ProceduresCardiomyopathy, HypertrophicDissectionEarly Medical InterventionEchocardiography, StressExercise TestFemaleHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePatient SelectionPractice Guidelines as TopicSeverity of Illness IndexSurvival AnalysisUnited StatesConceptsVentricular outflow tract gradientObstructive coronary artery diseaseBetter long-term survivalSurgical myectomyOutflow tract gradientObstructive hypertrophic cardiomyopathyCoronary artery diseaseLong-term survivalClass ITract gradientEarly surgeryArtery diseaseHypertrophic cardiomyopathyLeft ventricular outflow tract gradientAppropriate internal defibrillator dischargePrimary composite end pointBasal septal thicknessClass I indicationsPrimary composite eventsHypertrophic obstructive cardiomyopathyComposite end pointLong-term outcomesComposite eventsEarly referralObstructive cardiomyopathyLong-Term Outcomes of Patients With Mediastinal Radiation–Associated Coronary Artery Disease Undergoing Coronary Revascularization With Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting
Dunn AN, Donnellan E, Johnston DR, Alashi A, Reed GW, Jellis C, Krishnaswamy A, Gillinov AM, Svensson LG, Ellis S, Griffin BP, Kapadia SR, Pettersson GB, Desai MY. Long-Term Outcomes of Patients With Mediastinal Radiation–Associated Coronary Artery Disease Undergoing Coronary Revascularization With Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting. Circulation 2020, 142: 1399-1401. PMID: 33017210, DOI: 10.1161/circulationaha.120.046575.Peer-Reviewed Original Research
2019
Outcomes of Patients With Mediastinal Radiation-Associated Mitral Valve Disease Undergoing Cardiac Surgery
Donnellan E, Alashi A, Johnston DR, Gillinov AM, Pettersson GB, Svensson LG, Griffin BP, Desai MY. Outcomes of Patients With Mediastinal Radiation-Associated Mitral Valve Disease Undergoing Cardiac Surgery. Circulation 2019, 140: 1288-1290. PMID: 31589484, DOI: 10.1161/circulationaha.119.040546.Peer-Reviewed Original ResearchA novel machine learning-derived radiotranscriptomic signature of perivascular fat improves cardiac risk prediction using coronary CT angiography
Oikonomou EK, Williams MC, Kotanidis CP, Desai MY, Marwan M, Antonopoulos AS, Thomas KE, Thomas S, Akoumianakis I, Fan LM, Kesavan S, Herdman L, Alashi A, Centeno EH, Lyasheva M, Griffin BP, Flamm SD, Shirodaria C, Sabharwal N, Kelion A, Dweck MR, Van Beek EJR, Deanfield J, Hopewell JC, Neubauer S, Channon KM, Achenbach S, Newby DE, Antoniades C. A novel machine learning-derived radiotranscriptomic signature of perivascular fat improves cardiac risk prediction using coronary CT angiography. European Heart Journal 2019, 40: 3529-3543. PMID: 31504423, PMCID: PMC6855141, DOI: 10.1093/eurheartj/ehz592.Peer-Reviewed Original ResearchConceptsPerivascular adipose tissueFat attenuation indexCoronary CT angiographyCardiac risk predictionCoronary perivascular adipose tissueMajor adverse cardiac eventsCT angiographyRisk predictionHigh-risk plaque featuresPerivascular fat attenuation indexRadiomic featuresAdverse cardiac eventsConsecutive eligible participantsSCOT-HEART trialTraditional risk stratificationCoronary artery diseaseCoronary calcium scoreStandard coronary CT angiographyAcute myocardial infarctionCoronary inflammationCardiac eventsArtery diseaseCalcium scoreCardiac surgeryMACE predictionDifferent Histopathologic Diagnoses in Patients With Clinically Diagnosed Hypertrophic Cardiomyopathy After Surgical Myectomy
Alashi A, Desai RM, Khullar T, Hodges K, Rodriguez ER, Tan C, Popovic ZB, Thamilarasan M, Wierup P, Lever HM, Smedira NG, Desai MY. Different Histopathologic Diagnoses in Patients With Clinically Diagnosed Hypertrophic Cardiomyopathy After Surgical Myectomy. Circulation 2019, 140: 344-346. PMID: 31329486, DOI: 10.1161/circulationaha.119.040129.Peer-Reviewed Original ResearchCharacteristics and Outcomes in a Contemporary Group of Patients With Suspected Significant Mitral Stenosis Undergoing Treadmill Stress Echocardiography
Gentry JL, Parikh PK, Alashi A, Gillinov AM, Pettersson GB, Rodriguez LL, Popovic ZB, Sato K, Grimm RA, Kapadia SR, Tuzcu EM, Svensson LG, Griffin BP, Desai MY. Characteristics and Outcomes in a Contemporary Group of Patients With Suspected Significant Mitral Stenosis Undergoing Treadmill Stress Echocardiography. Circulation Cardiovascular Imaging 2019, 12: e009062. PMID: 31203672, DOI: 10.1161/circimaging.119.009062.Peer-Reviewed Original ResearchConceptsRight ventricular systolic pressureTreadmill stress echocardiographyVentricular systolic pressureStress echocardiographySystolic pressureMetabolic equivalentsMV gradientMitral proceduresHigh mortalityThoracic Surgeons scoreLong-term survivalAsymptomatic patientsCause mortalityPrimary outcomeSurgeons scoreConsecutive patientsImproved survivalContemporary patientsMV proceduresPatientsEchocardiographySignificant MSSurvival analysisModerate MSMortalityIncremental Prognostic Value of Exercise Stress Testing in Primary Prevention
Alashi A, Riaz H, Lang R, Seballos R, Feinleib S, Sukol R, Cho L, Cremer P, Jaber W, Griffin BP, Desai MY. Incremental Prognostic Value of Exercise Stress Testing in Primary Prevention. The American Journal Of Cardiology 2019, 124: 216-223. PMID: 31104779, DOI: 10.1016/j.amjcard.2019.04.021.Peer-Reviewed Original ResearchConceptsHeart rate recoveryIncremental prognostic valueC-reactive proteinPrimary preventionPrognostic valueLong-term eventsCV diseaseDerivation groupFamily historyValidation groupStandard risk factor assessmentProspective observational cohort studyContinuous net reclassification improvementConsecutive asymptomatic adultsPremature CV diseaseSuperior risk stratificationTreadmill stress testingFuture cardiovascular eventsObservational cohort studyExercise stress testingMultivariable survival analysisRisk factor assessmentNet reclassification improvementBeats/minStress testingLong-Term Outcomes After Aortic Valve Surgery in Patients With Asymptomatic Chronic Aortic Regurgitation and Preserved LVEF Impact of Baseline and Follow-Up Global Longitudinal Strain
Alashi A, Khullar T, Mentias A, Gillinov AM, Roselli EE, Svensson LG, Popovic ZB, Griffin BP, Desai MY. Long-Term Outcomes After Aortic Valve Surgery in Patients With Asymptomatic Chronic Aortic Regurgitation and Preserved LVEF Impact of Baseline and Follow-Up Global Longitudinal Strain. JACC Cardiovascular Imaging 2019, 13: 12-21. PMID: 30772216, DOI: 10.1016/j.jcmg.2018.12.021.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAortic ValveAortic Valve InsufficiencyAsymptomatic DiseasesChronic DiseaseEchocardiographyFemaleHeart Valve Prosthesis ImplantationHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesRisk AssessmentRisk FactorsStroke VolumeTime FactorsTreatment OutcomeVentricular Function, LeftConceptsLeft ventricular ejection fractionLV-GLS valuesChronic aortic regurgitationAortic valve surgeryAortic regurgitationGlobal longitudinal strainAV surgeryLV-GLSValve surgeryMean left ventricular ejection fractionAsymptomatic chronic aortic regurgitationChronic severe aortic regurgitationVentricular global longitudinal strainBetter long-term survivalHigher long-term mortalityLongitudinal strainPost-operative echocardiographySevere aortic regurgitationLong-term mortalityVentricular ejection fractionSubgroup of patientsLong-term survivalSubgroup of subjectsAV replacementBaseline echocardiographyAdult Patients With Marfan Syndrome and Ascending Aortic Surgery
Desai MY, Kalahasti V, Centeno E, Chen K, Alashi A, Rivas CG, Roselli EE, Johnston DR, Griffin BP, Svensson LG. Adult Patients With Marfan Syndrome and Ascending Aortic Surgery. Journal Of The American College Of Cardiology 2019, 73: 733-734. PMID: 30765040, DOI: 10.1016/j.jacc.2018.12.010.Peer-Reviewed Original ResearchDilation of the Proximal Thoracic Aorta in an Asymptomatic Primary Prevention Population Undergoing Noncontrast Chest Computed Tomography
Alashi A, Lang R, Seballos R, Feinleib S, Sukol R, Roselli EE, Svensson LG, Kalahasti V, Schoenhagen P, Flamm SD, Griffin BP, Desai MY. Dilation of the Proximal Thoracic Aorta in an Asymptomatic Primary Prevention Population Undergoing Noncontrast Chest Computed Tomography. Circulation 2019, 139: 557-558. PMID: 30586688, DOI: 10.1161/circulationaha.118.036191.Peer-Reviewed Original ResearchMeSH KeywordsAgedAortic Aneurysm, ThoracicAortographyAsymptomatic DiseasesComputed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseDilatation, PathologicEarly DiagnosisHumansIncidental FindingsMaleMiddle AgedPredictive Value of TestsPrimary PreventionUnited StatesVascular CalcificationConceptsAortic aneurysmDissection/rupturePrimary prevention populationCoronary artery calciumProximal thoracic aortaThoracic aortic aneurysmNoncontrast chestPrevention populationArtery calciumThoracic aortaSurgical techniqueSudden deathProximal ascendingTrue prevalenceImproved surveillanceAneurysmsEarly detectionDevastating diseaseDeathAortaChestMortalityPrevalenceDiseaseExsanguination
2018
Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center
Hodges K, Rivas CG, Aguilera J, Borden R, Alashi A, Blackstone EH, Desai MY, Smedira NG. Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center. Journal Of Thoracic And Cardiovascular Surgery 2018, 157: 2289-2299. PMID: 30782406, DOI: 10.1016/j.jtcvs.2018.11.148.Peer-Reviewed Original ResearchConceptsVentricular outflow tract obstructionOutflow tract obstructionMitral valve interventionLeft ventricular outflow tract obstructionTract obstructionSeptal myectomyValve interventionMitral interventionPostoperative ventricular septal defectContemporary surgical outcomesHypertrophic cardiomyopathy centersPapillary muscle resectionMitral valve replacementPermanent pacemaker insertionComplete heart blockMitral valve pathologyVentricular septal defectHospital outcomesOperative mortalityConcomitant proceduresValve replacementMuscle resectionSingle surgeonHeart blockRetrospective reviewCharacteristics and longer-term outcomes of paravalvular leak after aortic and mitral valve surgery
Shah S, Alashi A, Pettersson GB, Rodriguez LL, Gillinov AM, Grimm RA, Navia J, Kapadia SR, Svensson LG, Griffin BP, Desai MY. Characteristics and longer-term outcomes of paravalvular leak after aortic and mitral valve surgery. Journal Of Thoracic And Cardiovascular Surgery 2018, 157: 1785-1792.e1. PMID: 30414770, DOI: 10.1016/j.jtcvs.2018.08.096.Peer-Reviewed Original ResearchConceptsReoperative cardiac surgeryLong-term mortalityRight ventricular systolic pressureGreater paravalvular leakMitral valve surgeryVentricular systolic pressureParavalvular leakLong-term outcomesLong-term survivalSTS scoreMV surgeryValve surgeryInfectious etiologySystolic pressureMultivariable Cox survival analysisGreater long-term mortalityAortic paravalvular leakMean STS scoreThoracic Surgeons scoreMild paravalvular leakVentricular ejection fractionCox survival analysisExcellent perioperative outcomesPerioperative outcomesPrimary endpointNon-invasive detection of coronary inflammation using computed tomography and prediction of residual cardiovascular risk (the CRISP CT study): a post-hoc analysis of prospective outcome data
Oikonomou EK, Marwan M, Desai MY, Mancio J, Alashi A, Centeno E, Thomas S, Herdman L, Kotanidis CP, Thomas KE, Griffin BP, Flamm SD, Antonopoulos AS, Shirodaria C, Sabharwal N, Deanfield J, Neubauer S, Hopewell JC, Channon KM, Achenbach S, Antoniades C. Non-invasive detection of coronary inflammation using computed tomography and prediction of residual cardiovascular risk (the CRISP CT study): a post-hoc analysis of prospective outcome data. The Lancet 2018, 392: 929-939. PMID: 30170852, PMCID: PMC6137540, DOI: 10.1016/s0140-6736(18)31114-0.Peer-Reviewed Original ResearchMeSH KeywordsAdipocytesAdipose TissueAdolescentAdultAgedAged, 80 and overComputed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseCoronary VesselsFemaleFollow-Up StudiesHumansImaging, Three-DimensionalMaleMiddle AgedPlaque, AtheroscleroticPredictive Value of TestsProportional Hazards ModelsProspective StudiesRisk AssessmentSurvival AnalysisYoung AdultConceptsRight coronary arteryProximal right coronary arteryCardiac mortalityCoronary inflammationCoronary CTACoronary arteryDerivation cohortValidation cohortOutcome dataHealth Research Oxford Biomedical Research CentreCoronary artery disease indexHigh-risk plaque featuresPerivascular fat attenuation indexCoronary artery inflammationFat attenuation indexIntensive secondary preventionCardiovascular risk factorsResidual cardiovascular riskProspective outcome dataMajor coronary arteriesHounsfield unitsLeft circumflex arteryCox regression modelRisk predictionCardiac risk predictionRate of Progression of Aortic Stenosis and its Impact on Outcomes in Patients With Radiation-Associated Cardiac Disease A Matched Cohort Study
Donnellan E, Griffin BP, Johnston DR, Popovic ZB, Alashi A, Kapadia SR, Tuzcu EM, Krishnaswamy A, Mick S, Svensson LG, Desai MY. Rate of Progression of Aortic Stenosis and its Impact on Outcomes in Patients With Radiation-Associated Cardiac Disease A Matched Cohort Study. JACC Cardiovascular Imaging 2018, 11: 1072-1080. PMID: 29909108, DOI: 10.1016/j.jcmg.2018.04.019.Peer-Reviewed Original ResearchConceptsAortic valve replacementLong-term mortalityModerate aortic stenosisAortic stenosisRate of progressionPrior XRTLong-term survivalXRT groupHigher long-term mortalityAortic valve gradientMatched Cohort StudyComparison groupBasis of ageMediastinal radiotherapyCause mortalityValve gradientCohort studyValve replacementMore patientsXRT patientsPatientsHigh mortalityMortalityPrior exposureProgression
2017
Incremental Prognostic Utility of Left Ventricular Global Longitudinal Strain in Asymptomatic Patients With Significant Chronic Aortic Regurgitation and Preserved Left Ventricular Ejection Fraction
Alashi A, Mentias A, Abdallah A, Feng K, Gillinov AM, Rodriguez LL, Johnston DR, Svensson LG, Popovic ZB, Griffin BP, Desai MY. Incremental Prognostic Utility of Left Ventricular Global Longitudinal Strain in Asymptomatic Patients With Significant Chronic Aortic Regurgitation and Preserved Left Ventricular Ejection Fraction. JACC Cardiovascular Imaging 2017, 11: 673-682. PMID: 28624411, DOI: 10.1016/j.jcmg.2017.02.016.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAortic Valve InsufficiencyAsymptomatic DiseasesBiomechanical PhenomenaChronic DiseaseDisease ProgressionEchocardiography, Doppler, ColorFemaleHumansMaleMiddle AgedMyocardial ContractionPredictive Value of TestsPrognosisRetrospective StudiesRisk AssessmentRisk FactorsStroke VolumeTime FactorsVentricular Dysfunction, LeftVentricular Function, LeftConceptsLeft ventricular ejection fractionAortic valve surgeryChronic aortic regurgitationLong-term mortalityGlobal longitudinal strainRight ventricular systolic pressureVentricular global longitudinal strainLV end-systolic dimensionLV-GLSVentricular systolic pressureEnd-systolic dimensionVentricular ejection fractionAortic regurgitationAsymptomatic patientsTerm mortalityValve surgerySTS scoreEjection fractionSystolic pressurePrognostic utilityLeft ventricular global longitudinal strainMultivariable Cox survival analysisSevere chronic aortic regurgitationLongitudinal strainMean STS scoreAortic Cross-Sectional Area/Height Ratio and Outcomes in Patients With Bicuspid Aortic Valve and a Dilated Ascending Aorta
Masri A, Kalahasti V, Svensson LG, Alashi A, Schoenhagen P, Roselli EE, Johnston DR, Rodriguez LL, Griffin BP, Desai MY. Aortic Cross-Sectional Area/Height Ratio and Outcomes in Patients With Bicuspid Aortic Valve and a Dilated Ascending Aorta. Circulation Cardiovascular Imaging 2017, 10: e006249. PMID: 28592593, DOI: 10.1161/circimaging.116.006249.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnatomic LandmarksAortaAortic AneurysmAortic ValveAortographyBicuspid Aortic Valve DiseaseCause of DeathChi-Square DistributionComputed Tomography AngiographyDilatation, PathologicFemaleHeart Valve DiseasesHospital MortalityHumansKaplan-Meier EstimateMagnetic Resonance AngiographyMaleMiddle AgedMultidetector Computed TomographyMultivariate AnalysisOhioPredictive Value of TestsProportional Hazards ModelsRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeConceptsBicuspid aortic valve patientsProximal ascending aortaAortic valve patientsBicuspid aortic valveAortic areaCardiovascular deathAscending aortaAortic surgeryValve patientsAortic valveMultivariable Cox survival analysisRight ventricular systolic pressureLong-term cardiovascular mortalityContrast-enhanced thoracicThoracic Surgeons scoreSevere aortic stenosisVentricular systolic pressureCox survival analysisMagnetic resonance angiographyHeight ratioAortic regurgitationCardiovascular mortalitySurgeons scoreAortic stenosisImproved survival
2016
Long-Term Outcomes in Patients With Aortic Regurgitation and Preserved Left Ventricular Ejection Fraction
Mentias A, Feng K, Alashi A, Rodriguez LL, Gillinov AM, Johnston DR, Sabik JF, Svensson LG, Grimm RA, Griffin BP, Desai MY. Long-Term Outcomes in Patients With Aortic Regurgitation and Preserved Left Ventricular Ejection Fraction. Journal Of The American College Of Cardiology 2016, 68: 2144-2153. PMID: 27855803, DOI: 10.1016/j.jacc.2016.08.045.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionAV surgeryVentricular ejection fractionAortic regurgitationLong-term survivalEjection fractionSuch patientsLeft ventricleChronic severe aortic regurgitationSex-matched U.S. populationLV end-systolic dimensionMultivariate Cox survival analysisGreater aortic regurgitationHospital postoperative mortalityMean STS scoreThoracic Surgeons scoreAortic valve surgeryChronic aortic regurgitationSevere aortic regurgitationEnd-systolic dimensionSurvival of patientsLong-term outcomesRisk of deathCox survival analysisPostoperative mortalitySynergistic Utility of Brain Natriuretic Peptide and Left Ventricular Global Longitudinal Strain in Asymptomatic Patients With Significant Primary Mitral Regurgitation and Preserved Systolic Function Undergoing Mitral Valve Surgery
Alashi A, Mentias A, Patel K, Gillinov AM, Sabik JF, Popović ZB, Mihaljevic T, Suri RM, Rodriguez LL, Svensson LG, Griffin BP, Desai MY. Synergistic Utility of Brain Natriuretic Peptide and Left Ventricular Global Longitudinal Strain in Asymptomatic Patients With Significant Primary Mitral Regurgitation and Preserved Systolic Function Undergoing Mitral Valve Surgery. Circulation Cardiovascular Imaging 2016, 9: e004451. PMID: 27342145, DOI: 10.1161/circimaging.115.004451.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsymptomatic DiseasesBiomarkersCardiac Surgical ProceduresChi-Square DistributionEchocardiographyFemaleHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMitral ValveMitral Valve InsufficiencyMultivariate AnalysisMyocardial ContractionNatriuretic Peptide, BrainPredictive Value of TestsProportional Hazards ModelsRetrospective StudiesRisk AssessmentRisk FactorsStroke VolumeTime FactorsTreatment OutcomeVentricular Function, LeftVentricular Function, RightVentricular PressureConceptsLeft ventricular ejection fractionMitral valve surgeryVentricular ejection fractionLog-transformed BNPThoracic Surgeons scoreBrain natriuretic peptidePrimary mitral regurgitationRight ventricular systolic pressureSignificant primary mitral regurgitationVentricular systolic pressureGlobal longitudinal strainIncremental prognostic utilityLV-GLSAsymptomatic patientsValve surgeryEjection fractionMitral regurgitationSurgeons scoreNatriuretic peptideSystolic pressurePrognostic utilityBaseline LV global longitudinal strainBaseline right ventricular systolic pressureMitral effective regurgitant orificeLV global longitudinal strain