Clinical Value of the Tissue Doppler <i>S</i> Wave to Characterize Left Ventricular Hypertrophy as Defined by Echocardiography

Chejtman, Demián; Baratta, Sergio; Fernández, Horacio; Ferroni, F.; Bilbao, Jorge; Kotliar, C.; Marani, A.; Turri, D.; Hita, Alejandro

doi:10.1111/j.1540-8175.2009.01044.x

Cited by 5 publications

(8 citation statements)

References 30 publications

(49 reference statements)

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“…The other factors identified were related to relative reduction in LV systolic function. Mitral annular tissue Doppler S′ velocity has been shown to be reliably related to the degree of systolic dysfunction . We found poorer LVEF outcomes in both the low‐flow and normal‐flow populations with lower septal S′ velocity.…”

Section: Discussionmentioning

confidence: 58%

Comparing characteristics and clinical and echocardiographic outcomes in low‐flow vs normal‐flow severe aortic stenosis with preserved ejection fraction in an Asian population

et al. 2017

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Background/Objectives In severe aortic stenosis (AS), deterioration of left ventricular ejection fraction (LVEF) to <50% is an AHA/ACC class I indication for valve replacement, regardless of symptoms. Controversy surrounds prognosis of low‐flow AS compared to normal‐flow, and no study has examined LVEF deterioration. We compared factors associated with LVEF deterioration (to <50%) and clinical outcomes. Methods Consecutive subjects with low‐flow (stroke volume index <35 mL/m2, n=56) and normal‐flow (n=72) severe AS (aortic valve area <1 cm2) with preserved LVEF (>50%) and with paired echocardiography were studied. Univariate and multivariate analyses identified factors associated with LVEF deterioration. Clinical outcomes were determined on follow‐up for more than 5 years. Results Significant LVEF deterioration (to <50%) was seen in 18% of low‐flow (initial LVEF 63±8% to 32±9%) and 18% of normal‐flow AS (61±7% to 31±12%). Independent factors in low‐flow AS were hypertension (OR: 30.7, 95% CI: 2.0–467.6, P=.014) and higher end‐systolic wall stress (OR: 1.086, 95% CI: 1.022–1.153, P=.008), compared to normal‐flow, which were hypertension (OR: 15.9, 95% CI: 3.1–81.9, P=.001), higher septal E/E′ ratio (OR: 1.16, 95% CI: 1.01–1.35, P=.043), lower septal S′ velocity (OR: 0.204, 95% CI: 0.061–0.682, P=.010), and higher end‐systolic wall stress (OR: 1.051, 95% CI: 1.001–1.104, P=.047). Overall, a third of the cohort experienced MACE, regardless of flow (log‐rank 0.048, P=.827). However, aortic valve replacement (AVR) rates were lower in low‐flow AS (20% vs 43%, P=.005). Conclusions Low‐flow AS despite normal LVEF appears similar to normal‐flow in terms of LVEF deterioration and clinical outcomes in our Asian population. AVR rate was lower even though low‐flow may not reflect less severe disease.

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Section: Discussionmentioning

confidence: 58%

Comparing characteristics and clinical and echocardiographic outcomes in low‐flow vs normal‐flow severe aortic stenosis with preserved ejection fraction in an Asian population

et al. 2017

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“…Also, LV hypertrophy was related to increased total plasma volume in patients with PV 16 . Previous studies demonstrated negative effects of LV hypertrophy on LV functions by conventional and tissue Doppler echocardiography in various circumstances 17–19 . In addition, a positive and significant correlation of increased LV mass with myocardial dysfunction was demonstrated in the literature 20,21 .…”

Section: Discussionmentioning

confidence: 88%

Assessment of Left Ventricular Myocardial Performance by Tissue Doppler Echocardiography in Patients with Polycythemia Vera

Kayrak¹,

Acar

Gül³

et al. 2011

Echocardiography

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“…Previous studies showed supernormal diastolic performance of predominantly endurance athletes heart, 10,11 and improvement of LV myocardial compliance 12 which is reciprocally related to the chamber stiffness. It is also known that endurance training prevents myocardial stiffening with aging 13 …”

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confidence: 91%

“…7 Therefore, the subendocardial function is impaired in pathological hypertrophy, but should be normal in athletes, and Doppler myocardial imaging is preferred method for differentiating between these two conditions. 8,9 Previous studies showed supernormal diastolic performance of predominantly endurance athletes heart, 10,11 and improvement of LV myocardial compliance 12 which is reciprocally related to the chamber stiffness. It is also known that endurance training prevents myocardial stiffening with aging.…”

mentioning

confidence: 98%

Assessment of the Left Ventricular Chamber Stiffness in Athletes

Popović¹,

Ostojić²,

Petrović³

et al. 2010

Echocardiography

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Since diastolic dysfunction is an early sign of the heart disease, detecting diastolic disturbances is predicted to be the way for early recognizing underlying heart disease in athletes. So-called chamber stiffness index (E/e')/LVDd was predicted to be useful in distinguishing physiological from pathological left ventricular hypertrophy, because it was shown to be reduced in athletes. It remains unknown whether it is reduced in all athletic population. Standard and tissue Doppler were used to assess cardiac parameters at rest in 16 elite male wrestlers, 21 water polo player, and 20 sedentary subjects of similar age. In addition to (E/e')/LVDd index, a novel (E/e')/LVV, (E/e')/RVe'lat indices were determined. Progressive continuous maximal test on treadmill was used to assess the functional capacity. VO(2) max was the highest in water polo players, and higher in wrestlers than in controls. LVDd, LVV, LVM/BH(2.7) were higher in athletes. Left ventricular early diastolic filling velocity, deceleration and isovolumetric relaxation time did not differ. End-systolic wall stress was significantly higher in water polo players. RV e' was lower in water polo athletes. Right atrial pressure (RVE/e') was the highest in water polo athletes. (E/e'lat)/LVDd was not reduced in athletes comparing to controls (water polo players 0.83 ± 0.39, wrestlers 0.73 ± 0.29, controls 0.70 ± 0.28; P = 0.52), but (E/e's)/RVe'lat better distinguished examined groups (water polo players 0.48 ± 0.37, wrestlers 0.28 ± 0.15, controls 0.25 ± 0.16, P = 0.015) and it was the only index which predicted VO(2) max. In conclusion, intensive training does not necessarily reduce (E/e'lat)/LVDd index. A novel index (E/e's)/RVe'lat should be investigated furthermore in detecting diastolic adaptive changes.

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Clinical Value of the Tissue Doppler S Wave to Characterize Left Ventricular Hypertrophy as Defined by Echocardiography

Abstract: Peak "s" wave velocity and two indices: IC/s and BMDV are novel parameters that may allow to discriminate physiological from pathological forms of hypertrophy as well as different subtypes of hypertrophy.

Cited by 5 publications

References 30 publications

Comparing characteristics and clinical and echocardiographic outcomes in low‐flow vs normal‐flow severe aortic stenosis with preserved ejection fraction in an Asian population

Comparing characteristics and clinical and echocardiographic outcomes in low‐flow vs normal‐flow severe aortic stenosis with preserved ejection fraction in an Asian population

Assessment of Left Ventricular Myocardial Performance by Tissue Doppler Echocardiography in Patients with Polycythemia Vera

Assessment of the Left Ventricular Chamber Stiffness in Athletes

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