Speckle tracking echocardiographic assessment of left ventricular function by myocardial strain before and after aortic valve replacement

Kaler, Gajinder Pal Singh; Mahla, Rakesh; Mahla, Himanshu; Choudhary, Sarita; Singh, Gurdarshan; Patel, Raghuveer Prasad; Kaler, Navjot Kaur

doi:10.37616/2212-5043.1288

Cited by 4 publications

(1 citation statement)

References 38 publications

(26 reference statements)

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“…In the current work, both study and control groups were comparable in terms of age, gender, hypertension, diabetes mellitus, and smoking, which was consistent with Kaler et al [11] . We also discovered no significant difference in EF between the two groups.…”

Section: Discussionsupporting

confidence: 92%

Assessment of Left Ventricular Systolic Function by Three-Dimensional Echocardiography Pre and Post Aortic Valve Replacement in Patient with Severe Aortic Stenosis

Elsemelawy,

Abd El-kareem,

El- Abbady

et al. 2023

International Journal of Medical Arts

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Article informationBackground: Despite left ventricle [LV] dysfunction, the aortic valve replacement risk for aortic stenosis [AS] was acceptable and related mainly to coronary artery disease and mean aortic gradient. The long-term survival was related to cardiac output and coronary disease. The Aim of the work:To assess the potential role of threedimensional [3D] speckle tracking echocardiography [STE] in the detection of systolic dysfunction of the LV in severe aortic stenosis pre-and post-valve replacement.Patients and Methods: Forty patients with severe AS in the preand post-surgical valve replacement were enrolled and assigned as group A. Group [B] included [20] sex-and agematched apparently healthy individuals as a control group.Results: There was a statistically significant differences between groups on the 2D and 3D STE but the 2D STE was the most significant as regard the global longitudinal strain. After aortic valve replacement, basic echocardiographic parameters showed no significant differences after than before aortic valve replacement. However, there was a significant improvement of global longitudinal strain and global circumferential strain after than before surgery by 2D and 3D speckle tracking echocardiography. Conclusion:The speckle tracking echocardiography 2D or 3D is an optional significant modality for detection of subclinical left ventricular dysfunction in patients with severe aortic stenosis and preserved EF.

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Section: Discussionsupporting

confidence: 92%

Assessment of Left Ventricular Systolic Function by Three-Dimensional Echocardiography Pre and Post Aortic Valve Replacement in Patient with Severe Aortic Stenosis

Elsemelawy,

Abd El-kareem,

El- Abbady

et al. 2023

International Journal of Medical Arts

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Strain Assessment in Aortic Stenosis: Pathophysiology and Clinical Utility

Meredith,

Roy,

Hayward

et al. 2024

Journal of the American Society of Echocardiography

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Left Ventricular Hypertrophy in Aortic Stenosis: Early Cell and Matrix Regression 2 Months Post-Aortic Valve Replacement

Bennett,

Thornton,

Nitsche

et al. 2024

Circ: Cardiovascular Imaging

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BACKGROUND: In aortic stenosis, the myocardium responds with left ventricular hypertrophy, which is characterized by increased left ventricular mass due to cellular hypertrophy and extracellular matrix expansion. Following aortic valve replacement (AVR), left ventricular hypertrophy regression occurs, but early cellular and extracellular dynamics are unknown. METHODS: Patients with severe symptomatic aortic stenosis undergoing surgical or transcatheter AVR were prospectively recruited. Pre- and early post-AVR cardiac magnetic resonance imaging assessed left ventricular remodeling, global longitudinal strain, and T1 mapping to determine extracellular volume fraction and volume of cellular and extracellular compartments. RESULTS: In all, 39 patients (aged 71.4±9.8 years, male 79%, aortic valve peak velocity 4.4±0.5 m/s) underwent cardiac magnetic resonance before and at median 7.7 weeks post-AVR. Left ventricular mass index reduced significantly by 15.4% ( P <0.001*), primarily driven by cellular compartment regression (18.7%, P <0.001*), with a smaller reduction in the extracellular compartment (7.2%, P <0.001*). This unbalanced regression led to an apparent increase in extracellular volume fraction (27.4±3.1% to 30.2±2.8%; P <0.001*). Although there was no significant change in global longitudinal strain post-AVR, an increase in extracellular volume fraction was associated with worsening of global longitudinal strain (Pearson r=0.41, P =0.01). Mode of intervention (transcatheter versus surgical) did not influence the above myocardial parameters post-AVR (all P >0.05). The asterisk in P values indicates a statistical significance of <0.05. CONCLUSIONS: Within 8 weeks of AVR for aortic stenosis, substantial left ventricular hypertrophy regression occurs involving both cellular and extracellular compartments, demonstrating the early myocardial adaptability to afterload relief. Cellular compartment regression is greater than extracellular regression, leading to an apparent increase in extracellular volume fraction. Mode of intervention did not affect degree of reverse remodeling, indicating that both are effective at resulting beneficial changes post-AVR. REGISTRATION: URL: https://www.isrctn.com ; Unique identifier: NCT04627987.

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Speckle tracking echocardiographic assessment of left ventricular function by myocardial strain before and after aortic valve replacement

Cited by 4 publications

References 38 publications

Assessment of Left Ventricular Systolic Function by Three-Dimensional Echocardiography Pre and Post Aortic Valve Replacement in Patient with Severe Aortic Stenosis

Assessment of Left Ventricular Systolic Function by Three-Dimensional Echocardiography Pre and Post Aortic Valve Replacement in Patient with Severe Aortic Stenosis

Strain Assessment in Aortic Stenosis: Pathophysiology and Clinical Utility

Left Ventricular Hypertrophy in Aortic Stenosis: Early Cell and Matrix Regression 2 Months Post-Aortic Valve Replacement

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