Aortic Valve Disease and Vascular Mechanics: Two‐Dimensional Speckle Tracking Echocardiographic Analysis

Leite, Luís; Teixeira, Rogério; Oliveira-Santos, Manuel; Barbosa, António; Martins, Rui; Castro, Graça; Gonçalves, Lino; Pêgo, M.

doi:10.1111/echo.13236

Cited by 5 publications

(6 citation statements)

References 35 publications

(68 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CS of patients with aortic stenosis is lower than the patients with aortic regurgitation, but they are all lower than the healthy people. Interestingly, the survival rate of patients with baseline CS rate >0.88/s was significantly higher 59 . Moreover, the bicuspid aortic valve is also associated with aortic disease.…”

Section: Biomechanics Of Different Aortic Diseasesmentioning

confidence: 95%

See 1 more Smart Citation

Evaluation of aortic biomechanics in patients with aortic disease via imaging: A review

Wang

Gong

2021

J of Clinical Ultrasound

View full text Add to dashboard Cite

As a bridge between the heart and the arteries, the aorta plays an important role in the cardiovascular system. The morbidity and mortality of aortic disease are extremely high, which is a serious threat to human life. The biomechanical abnormality of the aorta is an important factor of a series of pathological changes in the aortic wall. At present, there are many imaging methods to evaluate the biomechanics of the aorta, which will benefit to the early diagnosis and treatment of aortic disease. In this review, we describe the application of various imaging methods and parameters in aortic disease.

show abstract

Section: Biomechanics Of Different Aortic Diseasesmentioning

confidence: 95%

“…Interestingly, the survival rate of patients with baseline CS rate >0.88/s was significantly higher. 59 Moreover, the bicuspid aortic valve is also associated with aortic disease.…”

Section: Other Cardiac Diseases Affecting the Aortamentioning

confidence: 99%

Evaluation of aortic biomechanics in patients with aortic disease via imaging: A review

Wang

Gong

2021

J of Clinical Ultrasound

View full text Add to dashboard Cite

show abstract

“…The sum of the outflow tract obstruction due to the calcified aortic valve leaflets and the reduced arterial compliance result in an increasing valvulo-arterial impedance, which in turn represents the factor opposing to ventricular ejection by absorbing the mechanical energy developed by the heart [ 4 ]. Several studies have also demonstrated that AS is linked to a stiff dilated aorta [ 5 , 6 ], as assessed by aortic stiffness with either clinical imaging tools [ 7 ] or computational models [ 8 , 9 , 10 ]. To supply the increased requirement of energy, the heart changes his shape and function and this process is well known as cardiac remodeling [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

On the Left Ventricular Remodeling of Patients with Stenotic Aortic Valve: A Statistical Shape Analysis

et al. 2021

View full text Add to dashboard Cite

The left ventricle (LV) constantly changes its shape and function as a response to pathological conditions, and this process is known as remodeling. In the presence of aortic stenosis (AS), the degenerative process is not limited to the aortic valve but also involves the remodeling of LV. Statistical shape analysis (SSA) offers a powerful tool for the visualization and quantification of the geometrical and functional patterns of any anatomic changes. In this paper, a SSA method was developed to determine shape descriptors of the LV under different degrees of AS and thus to shed light on the mechanistic link between shape and function. A total of n=86 patients underwent computed tomography (CT) for the evaluation of valvulopathy were segmented to obtain the LV surface and then were automatically aligned to a reference template by rigid registrations and transformations. Shape modes of the anatomical LV variation induced by the degree of AS were assessed by principal component analysis (PCA). The first shape mode represented nearly 50% of the total variance of LV shape in our patient population and was mainly associated to a spherical LV geometry. At Pearson’s analysis, the first shape mode was positively correlated to both the end-diastolic volume (p<0.01, R=0.814) and end-systolic volume (p<0.01, and R=0.922), suggesting LV impairment in patients with severe AS. A predictive model built with PCA-related shape modes achieved better performance in stratifying the occurrence of adverse events with respect to a baseline model using clinical demographic data as risk predictors. This study demonstrated the potential of SSA approaches to detect the association of complex 3D shape features with functional LV parameters.

show abstract

“…Speckle-tracking echocardiography (STE) has emerged as a reliable measurer of left ventricle (LV) 6 systolic function 23 due to its fast, accurate, angle-independent and offline processing of myocardial deformation. 24,25 It has already been proved as an important initial predictor of LV dysfunction in aortic valve diseases through the measurement of global longitudinal strain (GLS). 26 Since 2008, STE has also been used to evaluate vascular wall properties of proximal elastic arteries.…”

Section: Introductionmentioning

confidence: 99%

“…26 Since 2008, STE has also been used to evaluate vascular wall properties of proximal elastic arteries. 25,27 It assesses the circumferential and longitudinal deformation that an artery undergoes during the cardiac cycle. Its values, in particular circumferential ascending aortic strain and its rate, have been described as important complementary parameters to the classic echocardiographic evaluation of patients with aortic stenosis.…”

Section: Introductionmentioning

confidence: 99%

Aortic strain in bicuspid aortic valve: an analysis

Carlos

Freitas

Alves

et al. 2021

Int J Cardiovasc Imaging

Self Cite

View full text Add to dashboard Cite

Introduction: Bicuspid aortic valve (BAV) is frequently related to aortic valve disease and aortopathy and it is usually monitored by transthoracic echocardiography and computed tomography (CT) angiography. However, early markers of disease progression are not currently available. Speckletracking echocardiography (STE) has shown consistent results among other cardiac pathologies. The present study evaluated STE aortic and left ventricle (LV) strain prognostic value, their discriminative power and their correlation with the degree of valvular regurgitation. Methods:We retrospectively followed forty-eight adult patients with BAV and twenty gender and age matched controls for a median period of approximately twenty months, all with LV ejection fraction > 50% and without wall-motion abnormalities or poor acoustic window. We measured LV and aortic classic and STE parameters and we analysed their statistically significant differences, as well as their discriminative power of BAV presence. Hereinafter, we assessed their correlation with the primary cardiac outcome -aortic valve replacement (AVR) -through a COX regression analysis. Finally, our population with BAV was divided according to their severity of aortic regurgitation (AR) in none, mild, moderate or severe, and we evaluated: a) their echocardiographic parameters' differences throughout the disease; and b) which values predicted the existence of at least moderate AR. Results:In our sample, values of LV dimensions and aortic diameter were higher in BAV population.Regarding their mechanics, LV global longitudinal strain (GLS) was impaired (p<0.001) and aortic global circumferential strain (GCS) did not differ among the two groups. Aortic GLS was significantly increased (p=0.027) and was a reliable discriminator of BAV presence, though aortic diameter was better (area under the curve = 0.92). In BAV patients with AR, aortic GCS decreased with the increment of severity (p=0.004) and severe AR had an exponentially augmented aortic GLS (45.2 ± 32.3%). Aortic valve replacement was the only outcome observed and its only predictor was LV end-diastolic volume (indexed).Discussion: BAV patients had impaired LV contraction, despite having preserved LV ejection fraction.Our population had pronounced aortic dilatation, which caused a distortion in strain calculation, with high values of aortic GLS. Increasing severity of AR caused a reduction in aortic GCS, partly reflecting its significant vascular wall impairment throughout the disease.Conclusion: STE aortic strain was not a reliable predictor of surgery in BAV patients.

show abstract

Aortic Valve Disease and Vascular Mechanics: Two‐Dimensional Speckle Tracking Echocardiographic Analysis

Cited by 5 publications

References 35 publications

Evaluation of aortic biomechanics in patients with aortic disease via imaging: A review

Evaluation of aortic biomechanics in patients with aortic disease via imaging: A review

On the Left Ventricular Remodeling of Patients with Stenotic Aortic Valve: A Statistical Shape Analysis

Aortic strain in bicuspid aortic valve: an analysis

Contact Info

Product

Resources

About