Prognostic implications of cardiac magnetic resonance feature tracking derived multidirectional strain in patients with chronic aortic regurgitation

Fernández-Golfín, Covadonga; Hinojar-Baydes, Rocío; González-Gómez, A; Monteagudo, J M; Esteban, Amparo Cano; Salinas, Gonzalo Luis Alonso; Fernández, María Á.; García-Martín, Ana; Santoro, Ciro; Pascual-Izco, M; Jiménez-Nacher, José Julio; Zamorano, José Luís

doi:10.1007/s00330-020-07651-6

Cited by 16 publications

(20 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, AR has an additive effect on LV deformation in patients with T2DM, particularly LV function impairment. A series of studies about nondiabetic AR have shown that global longitudinal strain decreases early in the course of the disease and is a marker of AR severity [ 19 , 30 , 31 ]. The pathologic model of AR is an increase in preload and afterload, leading to LV eccentric hypertrophy, progressive dilation, and systolic dysfunction, which manifest microscopically as cardiomyocyte apoptosis and myocardial interstitial fibrosis similar to the pathological process of simple diabetic cardiomyopathy [ 10 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Additive effect of aortic regurgitation degree on left ventricular strain in patients with type 2 diabetes mellitus evaluated via cardiac magnetic resonance tissue tracking

Shen

Jiang

Zhu

et al. 2022

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background Type 2 diabetes mellitus causes left ventricular (LV) remodeling and increases the risk of aortic regurgitation (AR), which causes further heart damage. This study aimed to investigate whether AR aggravates LV deformation dysfunction and to identify independent factors affecting the global peak strain (PS) of LV remodeling in patients with type 2 diabetes mellitus (T2DM) who presented with AR and those without T2DM. Methods In total, 215 patients with T2DM and 83 age- and sex-matched healthy controls who underwent cardiac magnetic resonance examination were included. Based on the echocardiogram findings, T2DM patients with AR were divided into three groups (mild AR [n = 28], moderate AR [n = 21], and severe AR [n = 17]). LV function and global strain parameters were compared, and multivariate analysis was performed to identify the independent indicators of LV PS. Results The T2DM patients with AR had a lower LV global PS, peak systolic strain rate (PSSR), and peak diastolic strain rate (PDSR) in three directions than those without AR and non-T2DM controls. Patients without AR had a lower PS (radial and longitudinal) and PDSR in three directions and higher PSSR (radial and longitudinal) than healthy controls. Further, regurgitation degree was an independent factor of LV global radial, circumferential, and longitudinal PS. Conclusion AR may aggravate LV stiffness in patients with T2DM, resulting in lower LV strain and function. Regurgitation degree and sex were independently correlated with LV global PS in patients with T2DM and AR.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The radial strain had a positive value due to myocardium thickening during LV contraction. The circumferential and longitudinal strains had negative values because the myocardium shortened during contraction [ 18 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

Additive effect of aortic regurgitation degree on left ventricular strain in patients with type 2 diabetes mellitus evaluated via cardiac magnetic resonance tissue tracking

Shen

Jiang

Zhu

et al. 2022

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…When feature-tracking CMR was used to measure strain, LVGLS showed to be impaired early in the course of the disease and a marker of AR severity, while circumferential and radial strain worsened later and were associated with outcome, namely the need for aortic valve surgery. 92 …”

Section: The Myocardium In Aortic Regurgitationmentioning

confidence: 99%

Valvular heart disease: shifting the focus to the myocardium

Marsan

Delgado

Shah

et al. 2022

European Heart Journal

View full text Add to dashboard Cite

Adverse cardiac remodelling is the main determinant of patient prognosis in degenerative valvular heart disease (VHD). However, to give an indication for valvular intervention, current guidelines include parameters of cardiac chamber dilatation or function which are subject to variability, do not directly reflect myocardial structural changes, and, more importantly, seem to be not sensitive enough in depicting early signs of myocardial dysfunction before irreversible myocardial damage has occurred. To avoid irreversible myocardial dysfunction, novel biomarkers are advocated to help refining indications for intervention and risk stratification. Advanced echocardiographic modalities, including strain analysis, and magnetic resonance imaging have shown to be promising in providing new tools to depict the important switch from adaptive to maladaptive myocardial changes in response to severe VHD. This review, therefore, summarizes the current available evidence on the role of these new imaging biomarkers in degenerative VHD, aiming at shifting the clinical perspective from a valve-centred to a myocardium-focused approach for patient management and therapeutic decision-making.

show abstract

Section: Strain Analysismentioning

confidence: 99%

“…decreases early in the course of the disease and is a marker of AR severity [19,26,27]. The pathologic model of AR is an increase in preload and afterload, leading to LV eccentric hypertrophy, progressive dilation, and systolic dysfunction, which manifest microscopically as cardiomyocyte apoptosis and myocardial interstitial brosis similar to the pathological process of simple diabetic cardiomyopathy [10,28,29].…”

Section: Mechanical Damage In the Left Ventricular Myocardium Caused By T2dmmentioning

confidence: 99%

Additive Effect of Aortic Regurgitation Degree on Left Ventricular Strain in Patients with Type 2 Diabetes Mellitus Evaluated Via Cardiac Magnetic Resonance Tissue Tracking

Shen¹,

Jiang²,

Zhu³

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Type 2 diabetes mellitus causes left ventricular (LV) remodeling and increases the risk of aortic regurgitation (AR), which causes further heart damage. This study aimed to investigate whether AR aggravates LV deformation dysfunction and to identify independent factors affecting the global peak strain (PS) of LV remodeling in patients with type 2 diabetes mellitus (T2DM) who presented with AR and those without T2DM. Methods: In total, 215 patients with T2DM and 83 age- and sex-matched healthy controls who underwent cardiac magnetic resonance examination were included. Based on the echocardiogram findings, T2DM patients with AR were divided into three groups (mild AR [n = 28], moderate AR [n = 21], and severe AR [n = 17]). LV function and global strain parameters were compared, and multivariate analysis was performed to identify the independent indicators of LV PS. Results: The T2DM patients with AR had a lower LV global PS, peak systolic strain rate (PSSR), and peak diastolic strain rate (PDSR) in three directions than those without AR and non-T2DM controls. Patients without AR had a lower PS (radial and longitudinal) and PDSR in three directions and higher PSSR (radial and longitudinal) than healthy controls. Further, regurgitation degree was an independent factor of LV global radial, circumferential, and longitudinal PS. Conclusion: AR may aggravate LV stiffness in patients with T2DM, resulting in lower LV strain and function. Regurgitation degree and sex were independently correlated with LV global PS in patients with T2DM and AR.

show abstract

Prognostic implications of cardiac magnetic resonance feature tracking derived multidirectional strain in patients with chronic aortic regurgitation

Cited by 16 publications

References 25 publications

Additive effect of aortic regurgitation degree on left ventricular strain in patients with type 2 diabetes mellitus evaluated via cardiac magnetic resonance tissue tracking

Additive effect of aortic regurgitation degree on left ventricular strain in patients with type 2 diabetes mellitus evaluated via cardiac magnetic resonance tissue tracking

Valvular heart disease: shifting the focus to the myocardium

Additive Effect of Aortic Regurgitation Degree on Left Ventricular Strain in Patients with Type 2 Diabetes Mellitus Evaluated Via Cardiac Magnetic Resonance Tissue Tracking

Contact Info

Product

Resources

About