Strain analysis in patients with severe aortic stenosis and preserved left ventricular ejection fraction undergoing surgical valve replacement
Top Cited Papers
Open Access
- 2 September 2009
- journal article
- research article
- Published by Oxford University Press (OUP) in European Heart Journal
- Vol. 30 (24), 3037-3047
- https://doi.org/10.1093/eurheartj/ehp351
Abstract
To evaluate myocardial multidirectional strain and strain rate (S-and-SR) in severe aortic stenosis (AS) patients with preserved left ventricular (LV) ejection fraction (EF), using two-dimensional speckle-tracking strain imaging (2D-STI). The long-term effect of aortic valve replacement (AVR) on S-and-SR was also evaluated. Changes in LV radial, circumferential, and longitudinal S-and-SR were evaluated in 73 severe AS patients (65 ± 13 years; aortic valve area 0.8 ± 0.2 cm2) with preserved LVEF (61 ± 11%), before and 17 months after AVR. Strain and strain rate data were compared with data from 40 controls (20 healthy individuals and 20 patients with LV hypertrophy) matched by age, gender, body surface area, and LVEF. Compared with controls, severe AS patients had significantly decreased values of LV S-and-SR in the radial (33.1 ± 14.8%, P = 0.2; 1.7 ± 0.5 s−1, P = 0.003), circumferential (−15.2 ± 5.0%, P = 0.001; −0.9 ± 0.3 s−1, P < 0.0001), and longitudinal (−14.6 ± 4.1%, P < 0.0001; −0.8 ± 0.2 s−1, P < 0.0001) directions. At 17 months after AVR, LV S-and-SR significantly improved in all the three directions, whereas LVEF remained unchanged (60 ± 12%, P = 0.7). In severe AS patients, impaired LV S-and-SR existed although LVEF was preserved. After AVR, a significant S-and-SR improvement in all the three directions was observed. These subtle changes in LV contractility can be detected by 2D-STI.This publication has 32 references indexed in Scilit:
- Survival Benefit of Aortic Valve Replacement in Patients With Severe Aortic Stenosis With Low Ejection Fraction And Low Gradient With Normal Ejection FractionThe Annals of Thoracic Surgery, 2008
- Preoperative tissue Doppler imaging differentiates beneficial from detrimental left ventricular hypertrophy in patients with surgical aortic stenosis. A postoperative morbidity studyHeart, 2008
- Survival after valve replacement for aortic stenosis: Implications for decision makingThe Journal of Thoracic and Cardiovascular Surgery, 2008
- ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart DiseaseCirculation, 2006
- Two-Dimensional Strain–A Doppler-Independent Ultrasound Method for Quantitation of Regional Deformation: Validation In Vitro and In VivoJournal of the American Society of Echocardiography, 2005
- Mild and moderate aortic stenosis Natural history and risk stratification by echocardiographyEuropean Heart Journal, 2004
- Myocardial function defined by strain rate and strain during alterations in inotropic states and heart rateAmerican Journal of Physiology-Heart and Circulatory Physiology, 2002
- Can strain rate and strain quantify changes in regional systolic function during dobutamine infusion, B-blockade, and atrial pacing—implications for quantitative stress echocardiographyJournal of the American Society of Echocardiography, 2002
- Natural history of moderate aortic stenosisJournal of the American College of Cardiology, 1991
- Afterload mismatch and preload reserve: A conceptual framework for the analysis of ventricular functionProgress in Cardiovascular Diseases, 1976