Changes in systolic left ventricular function in isolated mitral regurgitation. A strain rate imaging study

Marciniak, Anna; Claus, Piet; Sutherland, George R.; Marciniak, Maciej; Karu, T.; Baltabaeva, Aigul; Merli, E; Bijnens, Bart; Jahangiri, Marjan

doi:10.1093/eurheartj/ehm072

Cited by 118 publications

(90 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16 The severity of LV dysfunction and remodeling was graded accordingly to the European Association and American Society of Echocardiography (EAE/ASE) guidelines.…”

mentioning

confidence: 99%

Maternal Cardiovascular Function in Normal Pregnancy

et al. 2016

View full text Add to dashboard Cite

Abstract-The aim of this study was to investigate cardiac functional status in pregnancy using a comprehensive approach taking into account the simultaneous changes in loading and geometry, as well as maternal age and anthropometric indices. This was a prospective cross-sectional study of 559 nulliparous pregnant women assessed at 4 time points during pregnancy and at 1 year postpartum. All women underwent conventional echocardiography and tissue Doppler velocities and strain rate analysis at multiple cardiac sites. Mean arterial pressure and total vascular resistance index significantly decreased (both P<0.001) during the first 2 trimesters of pregnancy and increased thereafter. Stroke volume index and cardiac index showed the opposite trend compared with mean arterial pressure and total vascular resistance index (both P<0.05). Myocardial and ventricular function were significantly enhanced in the first 2 trimesters but progressively declined thereafter. By the end of pregnancy, significant chamber diastolic dysfunction and impaired myocardial relaxation was evident in 17.9% and 28.4% of women, respectively, whereas myocardial contractility was preserved. There was full recovery of cardiac function at 1 year postpartum. Cardiovascular changes during pregnancy are thought to represent a physiological adaptation to volume overload. The findings of a drop in stroke volume index, impaired myocardial relaxation with diastolic dysfunction, and a tendency toward eccentric remodeling in a significant proportion of cases at term are suggestive of cardiovascular maladaptation to the volume-overloaded state in some apparently normal pregnancies. These unexpected cardiovascular findings have important implications for the management of both normal and pathological pregnancy states. Melchiorre et al Cardiac Function and Geometry in Pregnancy 755changes in maternal loading conditions, cardiac geometry, as well as age and anthropometric indices. MethodsThis was a prospective cross-sectional study performed over a 5-year period from June 2008 to February 2013. Healthy nulliparous women with singleton viable pregnancy were recruited consecutively from the routine antenatal clinic at St George's Hospital, University of London. The local institutional review committee approved the study, and all participants provided written informed consent. Women who subsequently developed adverse maternal complications, such as diabetes mellitus, preeclampsia, peripartum cardiomyopathy, pregnancy complication, or any other medical comorbidity, were excluded from the analysis. Women were recruited at 4 time points during pregnancy (11-14, 20-23, 28-32, and 37-39 weeks' gestation) and at 1 year postpartum after pregnancy care in our institution. A group of 50 nonpregnant healthy volunteer nulliparous women matched for age was also assessed to derive baseline echocardiographic values. All groups were matched for ethnicity and maternal age. To ensure that we recruited optimally healthy women, we also excluded women with a prepregnancy body mass...

show abstract

“…16 The severity of LV dysfunction and remodeling was graded accordingly to the European Association and American Society of Echocardiography (EAE/ASE) guidelines.…”

mentioning

confidence: 99%

Maternal Cardiovascular Function in Normal Pregnancy

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Evaluation of regional strain in the assessment of contiguous myocardial infarction has been docu-mented using echocardiography (18) and tagged MRI (13,14). The clinical importance of measuring myocardial contractility on PC-MRI was recently shown in a study by Delfino et al (19).…”

mentioning

confidence: 99%

Persistent decline in longitudinal and radial strain after coronary microembolization detected on velocity encoded phase contrast magnetic resonance imaging

Dicks

Carlsson

Heiberg

et al. 2009

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Purpose:To use velocity-encoded phase contrast (PC) MRI in assessing the effect of coronary microembolization on longitudinal and radial myocardial strain. Materials and Methods:A combined X-ray and MR system (XMR) was used for selective left anterior descending artery catheterization and microinfarct assessment in swine (n ϭ 6). The embolized area at risk was defined on perfusion MRI followed by administration of a 7500 count (size ϭ 100 -300 m) of the embolic agent. Quantification of strain and microinfarction was performed at 1 h and 1 week using PC-MRI and delayed enhancement (DE) MRI, respectively. At postmortem, sliced hearts were stained to define microinfarction.Results: Baseline longitudinal and radial strain did not differ between area-at-risk and remote myocardium. The embolized territory (area at risk) showed significant decline in longitudinal strain from Ϫ11.5 Ϯ 3.2% to 1.8 Ϯ 2.5% at 1 h (P Ͻ 0.05) and Ϫ3.9 Ϯ 1.1% at 1 week (P Ͻ 0.05). Similarly, regional radial strain progressively declined from 23.6 Ϯ 2.5% at baseline to 12.5 Ϯ 3.7% at 1 h (P Ͻ 0.05) and 4.8 Ϯ 5.0% at 1 week (P Ͻ 0.01). The size of microinfarction was not significantly different between DE-MRI and histochemical staining. Conclusion:PC-MRI is sensitive in assessing changes in regional longitudinal and radial strain after coronary embolization. Longitudinal and radial strain of the hyperenhanced patchy microinfarction demonstrates persistent decline over the course of 1 week.

show abstract

“…Hence, despite their ability to detect LV systolic dysfunction, these velocities do not predict subclinical dysfunction. 22 These could also be affected by the rheumatic affliction of mitral valve apparatus due to fibrosis and calcification which has not been emphasised by the authors. To characterise myocardial deformation, three fixed volume, or spatial region, were used for the strain and strain rate calculation from Doppler-derived myocardial velocity gradients and strain parameters were found to be lower in MR subjects and still lower in those with manifest LV systolic dysfunction.…”

Section: Figurementioning

confidence: 87%

“…Longitudinal and radial strain decrease with increasing LV end-diastolic size and hence, deformation must be corrected for altered geometry before it can provide meaningful clinical data. 22 An increase in size, without any change in stroke volume or contractility leads to a decrease in regional deformation. This finding is of importance when interpreting deformation values in patient groups like MR. A decrease in deformation indices does not necessarily mean that intrinsic myocardial function is decreased.…”

Section: Figurementioning

confidence: 99%