Tissue Velocities and Myocardial Deformation in Asymptomatic and Symptomatic Aortic Stenosis

Carstensen, Helena; Larsen, Lars Bruun; Hassager, Christian; Kofoed, Klaus F.; Dalsgaard, Morten; Kristensen, Charlotte Burup; Jensen, Jan Skov; Møgelvang, Rasmus

doi:10.1016/j.echo.2015.03.013

Cited by 20 publications

(16 citation statements)

References 42 publications

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“…LV systolic function has traditionally been assessed with 2D Simpson biplan LVEF, but this tool is being supplanted in a number of cardiomyopathies by LV strain analysis, which facilitates early detection of LV deformation abnormalities, before significant impairment of the LVEF has occurred . Moreover, strain measurement is more reliable than echocardiographic assessment of LVEF, as reflected by a significantly lower intra‐ and inter‐observer variability .…”

Section: Discussionmentioning

confidence: 99%

“…Whereas impairment of GLS in DM1 has already been described, the finding that early longitudinal LV deformation abnormalities are located in the apical region is novel. Differential alteration of longitudinal strain between the basal and the apical LV regions is a well‐known feature in some other cardiomyopathies . The only study examining regional LV deformation in DM1 found normal GLS in patients without a pacemaker and an apical longitudinal strain of −21.7% .…”

Section: Discussionmentioning

confidence: 99%

“…In consequence, early screening of LV myocardial dysfunction could identify patients at risk of sudden death. Two studies have assessed LV deformation abnormalities in DM1 using two‐dimensional (2D) speckle tracking which may facilitate earlier detection of LV systolic dysfunction than LVEF . However, data characterizing in detail the early stages of myocardial systolic dysfunction in DM1 are scarce.…”

Section: Introductionmentioning

confidence: 99%

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Apical left ventricular myocardial dysfunction is an early feature of cardiac involvement in myotonic dystrophy type 1

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Apical left ventricular myocardial dysfunction is an early feature of cardiac involvement in myotonic dystrophy type 1

et al. 2017

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“…22 On the other hand, in symptomatic severe AS patients with preserved EF, global longitudinal strain and strain rate were lower than in asymptomatic severe or moderate AS patients with preserved EF. 23 In the present study, even after adjusting for MCF, which is highly correlated with LV strain, DWS and K LV were associated with HF symptoms. Therefore, these results suggest that the association between LV myocardial or chamber stiffness with HF symptoms is independent from the impairment of LV systolic function.…”

Section: Discussionmentioning

confidence: 41%

Increased Left Ventricular Diastolic Stiffness Is Associated With Heart Failure Symptoms in Aortic Stenosis Patients With Preserved Ejection Fraction

Kamimura

Suzuki

Fox

et al. 2017

Journal of Cardiac Failure

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Background Clinical risk factors associated with heart failure (HF) symptoms in aortic stenosis (AS) patients with preserved ejection fraction (EF) have not been fully identified. We hypothesized that left ventricular (LV) diastolic stiffness is associated with HF symptoms in patients with AS. Methods and Results We retrospectively evaluated 275 patients with at least moderate AS (aortic valve area <1.5 cm2) and preserved EF (≥50%). LV diastolic stiffness was evaluated with the use of echocardiographic parameters, diastolic wall strain (DWS, a measure of LV wall stiffness), and KLV (a marker of LV chamber stiffness). There were 69 patients with HF. Patients with HF were older, were more likely to be African American, had a higher body mass index, and had more hypertension and coronary artery disease (P < .05 for all). Aortic valve area index and mean pressure gradient across the aortic valve were not different between patients with and without HF. Despite similar echocardiographic parameters of AS severity, patients with HF had stiffer LV (DWS 0.21 ± 0.06 vs 0.25 ± 0.06 [P < .01], KLV 0.17 ± 0.11 vs 0.13 ± 0.08 [P < .01]). Logistic regression analyses revealed that after adjusting for age, race, body mass index, history of hypertension, and coronary artery disease, LV diastolic stiffness parameters remained significantly associated with HF symptoms. Conclusions LV diastolic stiffness is independently associated with HF in AS patients with preserved EF.

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“…Other studies have established that regional deformation analysis is also important, with an additional parameter called basal longitudinal strain (BLS) less than -13% associated with adverse outcomes including heart failure, MI, all-cause mortality, and symptomatic status in asymptomatic severe AS. In fact, BLS has the strongest association with symptomatic status of all the longitudinal strain parameters[33]. Kempny et al[34] studied 101 patients undergoing TAVR and showed that pre-echocardiographic assessment of GLS is associated with post-operative symptom improvement.…”

Section: Aortic Stenosismentioning

confidence: 99%

Newer echocardiographic techniques for aortic-valve imaging: Clinical aids today, clinical practice tomorrow

Tiwari

Patel

2017

WJC

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Increasing life expectancy is expected to lead to a corresponding increase in the prevalence of aortic valve disease (AVD). Further, the number of indications for transcatheter aortic valve replacement (TAVR) as a treatment option for AVD is expanding, with a growing role for echocardiography in its management. In this review we summarize the current literature on some newer echocardiographic modalities and the parameters they generate, with a particular focus on their prognostic and clinical value beyond conventional methods in the management of aortic stenosis, TAVR, and aortic regurgitation. Speckle tracking and 3D echocardiography are now increasingly being used in the management of AVD. For instance, global longitudinal strain, the best-studied speckle tracking echocardiographic parameter, can detect subtle subclinical cardiac dysfunction in patients with AVD that is not apparent using traditional echocardiographic techniques. The emerging technique of 3D full volume color Doppler echocardiography provides more accurate measurement of the severity of aortic regurgitation than 2D-proximal isovelocity surface area. These novel techniques are promising for evaluating and risk stratifying patients to optimize surgical interventions, predict recovery, and improve clinical outcomes.

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Tissue Velocities and Myocardial Deformation in Asymptomatic and Symptomatic Aortic Stenosis

Cited by 20 publications

References 42 publications

Apical left ventricular myocardial dysfunction is an early feature of cardiac involvement in myotonic dystrophy type 1

Apical left ventricular myocardial dysfunction is an early feature of cardiac involvement in myotonic dystrophy type 1

Increased Left Ventricular Diastolic Stiffness Is Associated With Heart Failure Symptoms in Aortic Stenosis Patients With Preserved Ejection Fraction

Newer echocardiographic techniques for aortic-valve imaging: Clinical aids today, clinical practice tomorrow

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