Two dimensional speckle tracking echocardiography in detection of subclinical left ventricular systolic dysfunction in patients with severe aortic stenosis

Younan, Hany

doi:10.1016/j.ihj.2014.10.400

Cited by 3 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…GLS was shown to be significantly negatively associated with LV mass as well as LV volume in systole and diastole; when left ventricular mass and volume increased, GLS worsened. Decreased GLS with increased LV wall thickness and mass has been previously demonstrated in patients with LV hypertrophy from aortic stenosis with the premise that systolic dysfunction and/or inflammation results in abnormalities in strain before overt changes in systolic function occur …”

Section: Discussionmentioning

confidence: 80%

“…Decreased GLS with increased LV wall thickness and mass has been previously demonstrated in patients with LV hypertrophy from aortic stenosis with the premise that systolic dysfunction and/or inflammation results in abnormalities in strain before overt changes in systolic function occur. 50 Future studies incorporating a larger number of rejection episodes are needed to further delineate the role of GLS in identifying rejection.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Feasibility and interpretation of global longitudinal strain imaging in pediatric heart transplant recipients

Wisotzkey

Jorgensen

Albers

et al. 2017

Pediatric Transplantation

View full text Add to dashboard Cite

Evaluation of myocardial mechanics after heart transplant is important in monitoring allograft function and identifying rejection. Speckle tracking global longitudinal strain (GLS) may be more sensitive to early regional changes from rejection. This study aimed to determine feasibility of GLS in pediatric hearts during surveillance echocardiograms, compare their GLS to published norms (-18% to -22%), and assess association of GLS with other indices of graft function. Retrospective review of transplant echocardiograms from 2013 to 2014. Philips QLAB was used for post-acquisition GLS analysis. Multiple linear regression was used to assess the association of GLS with echocardiographic/catheterization indices, and B-type natriuretic peptide (BNP). Forty-seven patients (84 studies) were included. Calculation of GLS was feasible in 82 studies (97%) with inter- and intra-observer variability of 0.71 and 0.69. Patients (n=9) with rejection had GLS of -16.4% (SD=3.5%) compared to those without [-16.8% (SD=3.7%)]. GLS worsened linearly with increasing Ln(BNP) (P=<.001), left ventricular volume in diastole (P=<.001), septal a' wave (P=<.001), and pulmonary capillary wedge pressure (P=<.001). Speckle tracking-based GLS is feasible and reproducible in pediatric heart recipients and is reduced at baseline. The role of GLS and BNP in detecting early systolic dysfunction warrants further investigation.

show abstract

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Feasibility and interpretation of global longitudinal strain imaging in pediatric heart transplant recipients

Wisotzkey

Jorgensen

Albers

et al. 2017

Pediatric Transplantation

View full text Add to dashboard Cite

show abstract

“…Younan et al [18] showed a negative correlation of GLS with LVMI. Similar results were obtained by Cramariuc et al [19].…”

Section: Discussionmentioning

confidence: 94%

Exercise-induced changes in left ventricular global longitudinal strain in asymptomatic severe aortic stenosis

et al. 2017

View full text Add to dashboard Cite

A b s t r a c t Background:The management of patients with asymptomatic severe aortic stenosis (ASAS) is still under discussion. Therefore, it is advisable to search for the parameters of early damage to left ventricular (LV) function. Aim:The aim of the study was to assess exercise-induced changes in LV global longitudinal strain (GLS) in ASAS. Methods:The ASAS group consisted of 50 patients (26 women and 24 men, aged 38.4 ± 18.1 years) meeting the echocardiographic criteria of severe aortic stenosis (AVA < 1 cm 2 , AVAI < 0.6 cm 2 /m 2 , Vmax > 4 m/s, mean aortic gradient > 40 mm Hg), with normal LV ejection fraction (LVEF ≥ 55%) and sinus rhythm on electrocardiogram, and without significant concomitant valvular heart diseases. The control group consisted of 21 people matched for age and sex. Echocardiographic examinations and echocardiographic stress tests with the assessment of GLS using the speckle tracking imaging were performed. Results:The ASAS group was characterised by statistically significantly higher LV mass index (LVMI) and higher LVEF. GLS values at rest in both groups were within normal limits but were significantly higher in the control group (-18.9 ± 2.4% vs. -20.7 ± 1.7%, p = 0.006). An increase in GLS at peak exercise in both groups was observed, lower in the ASAS group (the difference was not statistically significant: -0.8 ± 3.0% vs. -2.2 ± 3.1%, p = 0.086). Changes in GLS during exercise (∆GLS) did not correlate with the parameters of the severity of aortic stenosis. In the multivariate model, LVMI proved to be a factor associated with GLS at rest and during exercise. Conclusions:In patients with ASAS, GLS is a non-invasive marker of an early stage of LV myocardial damage associated with myocardial hypertrophy. An increase in GLS during exercise in the ASAS group, smaller than in the control group, indicates a preserved functional reserve of the LV myocardium but smaller than in healthy individuals. The assessment of the clinical usefulness of exercise-induced changes in GLS requires further research.

show abstract

Evaluation of left ventricular function using speckle tracking echocardiography in patients with severe aortic stenosis with or without symptoms

et al. 2021

View full text Add to dashboard Cite

Background: Speckle tracking echocardiography (STE) may be useful in early detection of contractile dysfunction in severe aortic stenosis (AS) patients. Aims and Objectives: The present study aims to evaluate the global longitudinal strain (GLS), global circumferential strain (GCS), and strain rates in patients with severe AS and the role of STE in predicting the development of symptoms or left ventricular (LV) dysfunction in them. Methods and Results: This was a single-centered, prospective, observational study, done at a tertiary care hospital in north India. The study recruited 30 patients with severe AS and 10 healthy controls. Patients underwent two-dimensional echocardiography and STE at baseline and 6 months. Baseline characteristics were similar between the cases and controls. Majority of severe AS patients were symptomatic (n = 24; 80%). LV ejection fraction (LVEF) was similar between cases and controls at baseline and 6 months. Cases had a significantly worse GLS (−-19.3 ± 5.66 vs. -30.4 ± 3.63), GCS (−-29.6 ± 8.48 vs. −-33.6 ± 2.55), and strain rate parameters than the controls at baseline and had a significant decline in these parameters at 6 months. Among 6 asymptomatic patients, 3 developed symptoms and these patients had a significantly greater decline in GLS at 6 months as compared to asymptomatic patients. Conclusions: The present study revealed that patients with severe AS had an abnormal GLS and GCS to begin with, which was not picked by LVEF. Further, there was a significant worsening of these STE parameters at 6 months and those who had a greater decline were more likely to develop new symptoms.

show abstract

Two dimensional speckle tracking echocardiography in detection of subclinical left ventricular systolic dysfunction in patients with severe aortic stenosis

Abstract: Patients with severe AS have evidence of subclinical LV systolic dysfunction despite preserved EF%. 2D speckle tracking appears to be useful in detection of subclinical LV dysfunction in patients with AS.

Cited by 3 publications

References 16 publications

Feasibility and interpretation of global longitudinal strain imaging in pediatric heart transplant recipients

Feasibility and interpretation of global longitudinal strain imaging in pediatric heart transplant recipients

Exercise-induced changes in left ventricular global longitudinal strain in asymptomatic severe aortic stenosis

Evaluation of left ventricular function using speckle tracking echocardiography in patients with severe aortic stenosis with or without symptoms

Contact Info

Product

Resources

About