Chronic Mitral Regurgitation: A Pilot Study to Assess Preoperative Left Ventricular Contractile Function Using Speckle-Tracking Echocardiography

Isla, Leopoldo Pérez de; Agustin, José Alberto de; Rodrigo, José Luis; Almerı́a, Carlos; Manzano, María del Carmen; Rodríguez, Enrique; Garcia, Ana Luís; Macaya, Carlos; Zamorano, José Luís

doi:10.1016/j.echo.2009.04.016

Cited by 58 publications

(37 citation statements)

References 39 publications

(65 reference statements)

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“…We found a lower prevalence of previous CABG in our population (5.6%) of unselected ACS patients, in contrast with rates of 20% previously reported in observational studies, 6,7 but similar to the data most recently published by the Valiant trial (7%). 17 In addition, it is worth noting that the prevalence of previous percutaneous revascularization was higher (9.6%, data not shown) for the overall population, probably reflecting an overall change in the treatment of coronary artery disease As in other published series, our patients with a history of CABG were older, more often male, and more likely to have diabetes and a history of…”

Section: Discussion Baseline Datacontrasting

confidence: 56%

“…5 On the other hand, observational studies on acute coronary syndromes (ACS) noted an overall prevalence of 20% for patients with a history of CABG. 6,7 In these patients, there are 2 potential explanations, not mutually exclusive, for a new major coronary event, namely, progression of atherosclerotic disease in native arteries or the development of vascular disease in the grafts. Previous authors of an angiography study reported 8% venous graft failure at 1 year, 38% at 5 years, and 75% at 10 years after surgery, 8 and progression of the atherosclerotic process in up to 51% 15 years after CABG.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Can We Improve Outcomes in Patients With Previous Coronary Artery Bypass Surgery Admitted for Acute Coronary Syndrome?

Teixeira

Lourenço

António

et al. 2010

Revista Española de Cardiología (English Edition)

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Section: Discussion Baseline Datacontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Can We Improve Outcomes in Patients With Previous Coronary Artery Bypass Surgery Admitted for Acute Coronary Syndrome?

Teixeira

Lourenço

António

et al. 2010

Revista Española de Cardiología (English Edition)

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“…The chronic effects of abnormal loading from valvular disease on myocardial function may be difficult to detect by conventional means, and strain imaging may play a role (61)(62)(63)(64)(65)(66)(67). Delgado et al (62) demonstrated that patients with severe aortic stenosis and preserved EF exhibited decreased radial, circumferential, and longitudinal speckle tracking strain.…”

Section: Applications Of Strain Imaging For Effects Of Valvular Heartmentioning

confidence: 98%

Echocardiographic Assessment of Myocardial Strain

Gorcsan¹,

Tanaka²

2011

Journal of the American College of Cardiology

414

305

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Echocardiographic strain imaging, also known as deformation imaging, has been developed as a means to objectively quantify regional myocardial function. First introduced as post-processing of tissue Doppler imaging velocity converted to strain and strain rate, strain imaging has more recently also been derived from digital speckle tracking analysis. Strain imaging has been used to gain greater understanding into the pathophysiology of cardiac ischemia and infarction, primary diseases of the myocardium, and the effects of valvular disease on myocardial function, and to advance our understanding of diastolic function. Strain imaging has also been used to quantify abnormalities in the timing of mechanical activation for heart failure patients undergoing cardiac resynchronization pacing therapy. Further advances, such as 3-dimensional speckle tracking strain imaging, have emerged to provide even greater insight. Strain imaging has become established as a robust research tool and has great potential to play many roles in routine clinical practice to advance the care of the cardiovascular patient. This perspective reviews the physiology of myocardial strain, the technical features of strain imaging using tissue Doppler imaging and speckle tracking, their strengths and weaknesses, and the state-of-the-art present and potential future clinical applications.

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“…Speckle-tracking echocardiography is a new, angle-independent imaging modality that has been shown to detect even subtle changes sensitively in myocardial function in a variety of cardiac diseases. [6][7][8][9][10][11][12] By frame-to-frame analysis of natural markers (speckles) within the myocardium, one can obtain with adequate reproducibility the peak longitudinal strain (PLS) as the ratio of change in length to the initial length and peak longitudinal strain rate (PLSR) as the rate at which deformation occurs, which is expressed in s −1 . [13][14][15] In patients with severe AS, LV strain and strain rate may be impaired, despite preserved LVEF.…”

Section: Clinical Perspective On P 276mentioning

confidence: 99%

Two-Dimensional Strain for the Assessment of Left Ventricular Function in Low Flow–Low Gradient Aortic Stenosis, Relationship to Hemodynamics, and Outcome

Bartko

Heinze

Graf

et al. 2013

Circ: Cardiovascular Imaging

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Background-Decision making in patients with low flow-low gradient aortic stenosis mainly depends on the actual stenosis severity and left ventricular function, which is of prognostic importance. We used 2-dimensional strain parameters measured by speckle tracking at rest and during dobutamine stress echocardiography to document the extent of myocardial impairment, its relationship with hemodynamic variables, and its prognostic value. Methods and Results-In 47 patients with low flow-low gradient aortic stenosis, global peak systolic longitudinal strain (PLS) and peak systolic longitudinal strain rate (PLSR) were analyzed. PLS and PLSR at rest and peak stress were −7.56±2.34% and −7.41±2.89% (P=NS) and −0.38±0.12 s −1 and −0.53±0.18 s −1 (P<0.001), respectively. PLS and PLSR inversely correlated with left ventricular ejection fraction at rest (r s =−0.52; P<0.0001 and −0.38; P=0.008) and peak stress (r s =−0.39; P=0.007 and −0.45; P=0.002). The overall 2-year survival rate was 60%. Univariate predictors of survival were peak stress left ventricular ejection fraction (P=0.0026), peak stress PLS (P=0.0002), peak stress PLSR (P<0.0001), and N-terminal pro-B-type natriuretic peptide (P<0.0001). Three hierarchically nested multivariable Cox regression models were constructed-model 1: The Society of Thoracic Surgeons score as an indicator of clinical risk (area under the receiver operating characteristic=0.59); model 2: model 1+N-terminal pro-B-type natriuretic peptide and peak stress left ventricular ejection fraction (area under the receiver operating characteristic=0.83; incremental P<0.0001); model 3: model 2+peak stress PLSR (area under the receiver operating characteristic=0.89; incremental P=0.035). Key Words: aortic stenosis ◼ Doppler echocardiography ◼ heart failure ◼ low flow ◼ myocardial strain ◼ stress echocardiography Conclusions-In

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Chronic Mitral Regurgitation: A Pilot Study to Assess Preoperative Left Ventricular Contractile Function Using Speckle-Tracking Echocardiography

Cited by 58 publications

References 39 publications

Can We Improve Outcomes in Patients With Previous Coronary Artery Bypass Surgery Admitted for Acute Coronary Syndrome?

Can We Improve Outcomes in Patients With Previous Coronary Artery Bypass Surgery Admitted for Acute Coronary Syndrome?

Echocardiographic Assessment of Myocardial Strain

Two-Dimensional Strain for the Assessment of Left Ventricular Function in Low Flow–Low Gradient Aortic Stenosis, Relationship to Hemodynamics, and Outcome

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