Impaction of regurgitation jet on anterior mitral leaflet is associated with diastolic dysfunction in patients with bicuspid aortic valve and mild insufficiency: a cardiovascular magnetic resonance study

Galea, Nicola; Pambianchi, Giacomo; Cundari, Giulia; Sturla, Francesco; Marchitelli, Livia; Putotto, Carolina; Versacci, Paolo; Paulis, Ruggero De; Francone, Marco; Catalano, Carlo

doi:10.1007/s10554-021-02384-z

Cited by 4 publications

(3 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bicuspid aortic valve with mild regurgitation and pEF may result in diastolic dysfunction uncovering by cardiac magnetic resonance feature tracking (CMR-FT) strain imaging as a Supplementary method . Depending on the regurgitation jet direction, a significant reduction in the circumferential and especially longitudinal strain rate has been observed, indicating that they might silently be in the progressive process that finally results in HF ( 47 ).…”

Section: Discussionmentioning

confidence: 99%

Intra-cardiac pressure drop and flow distribution of bicuspid aortic valve disease in preserved ejection fraction

Aliabadi

Sojoudi

Bandali

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundBicuspid aortic valve (BAV) is more than a congenital defect since it is accompanied by several secondary complications that intensify induced impairments. Hence, BAV patients need lifelong evaluations to prevent severe clinical sequelae. We applied 4D-flow magnetic resonance imaging (MRI) for in detail visualization and quantification of in vivo blood flow to verify the reliability of the left ventricular (LV) flow components and pressure drops in the silent BAV subjects with mild regurgitation and preserved ejection fraction (pEF).Materials and methodsA total of 51 BAV patients with mild regurgitation and 24 healthy controls were recruited to undergo routine cardiac MRI followed by 4D-flow MRI using 3T MRI scanners. A dedicated 4D-flow module was utilized to pre-process and then analyze the LV flow components (direct flow, retained inflow, delayed ejection, and residual volume) and left-sided [left atrium (LA) and LV] local pressure drop. To elucidate significant diastolic dysfunction in our population, transmitral early and late diastolic 4D flow peak velocity (E-wave and A-wave, respectively), as well as E/A ratio variable, were acquired.ResultsThe significant means differences of each LV flow component (global measurement) were not observed between the two groups (p > 0.05). In terms of pressure analysis (local measurement), maximum and mean as well as pressure at E-wave and A-wave timepoints at the mitral valve (MV) plane were significantly different between BAV and control groups (p: 0.005, p: 0.02, and p: 0.04 and p: <0.001; respectively). Furthermore, maximum pressure and pressure difference at the A-wave timepoint at left ventricle mid and left ventricle apex planes were significant. Although we could not find any correlation between LV diastolic function and flow components, Low but statistically significant correlations were observed with local pressure at LA mid, MV and LV apex planes at E-wave timepoint (R: −0.324, p: 0.005, R: −0.327, p: 0.004, and R: −0.306, p: 0.008, respectively).ConclusionIn BAV patients with pEF, flow components analysis is not sensitive to differentiate BAV patients with mild regurgitation and healthy control because flow components and EF are global parameters. Inversely, pressure (local measurement) can be a more reliable biomarker to reveal the early stage of diastolic dysfunction.

show abstract

Section: Discussionmentioning

confidence: 99%

Intra-cardiac pressure drop and flow distribution of bicuspid aortic valve disease in preserved ejection fraction

Aliabadi

Sojoudi

Bandali

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…CMR feature-tracking analysis of LV strain was performed using ventricular short- and long-axis views in cineMR images in a semiautomatic way. LV myocardial tracking was visually reviewed, contouring errors were corrected, and the analysis was repeated as previously described [ 24 , 25 ]. We finally reported the average value of three repeated measurements of global radial (GR-), circumferential (GC-), and longitudinal (GL-) strain (-S) and strain rate (-SR).…”

Section: Methodsmentioning

confidence: 99%

Takotsubo syndrome: left atrial and ventricular myocardial strain impairment in the subacute and convalescent phases assessed by CMR

Pambianchi,

Marchitelli,

Cundari

et al. 2024

Eur Radiol Exp

Self Cite

View full text Add to dashboard Cite

Background We investigated the differences in impairment of left ventricle (LV) and left atrium (LA) contractile dysfunction between subacute and convalescent takotsubo syndrome (TTS), using myocardial strain analysis by cardiac magnetic resonance (CMR) feature-tracking technique. Methods We retrospectively selected 50 patients with TTS clinical-radiological diagnosis who underwent CMR within 30 days since symptoms onset: 19 studied during the early subacute phase (sTTS, ≤ 7 days) and 31 during the convalescence (cTTS, 8–30 days). We measured the following: LV global longitudinal, circumferential, and radial strain (lvGLS, lvGCS, lvGRS) and strain rate (SR) and LA reservoir (laS_r), conduit (laS_cd), and booster pump strain (laS_bp) and strain rate (laSR_r, laSR_cd, laSR_bp). Patients were compared with 30 age- and sex-matched controls. Results All patients were women (mean age 63 years). TTS patients showed altered LV- and LA-strain features, compared to controls. sTTS was associated with increased laS_bp (12.7% versus 9.8%) and reduced lvEF (47.4% versus 54.8%), lvGLS (-12.2% versus 14.6%), and laS_cd (7.0% versus 9.5%) compared to cTTS (p ≤ 0.029). The interval between symptoms onset and CMR was correlated with laS_bp (r = -0.49) and lvGLS (r = 0.47) (p = 0.001 for both). At receiver operating characteristics analysis, laS_bp was the best discriminator between sTTS and cTTS (area under the curve [AUC] 0.815), followed by lvGLS (AUC 0.670). Conclusions LA dysfunction persists during the subacute and convalescence of TTS. laS_bp increases in subacute phase with progressive decrease during convalescence, representing a compensatory mechanism of LV dysfunction and thus a useful index of functional recovery. Relevance statement Atrial strain has the potential to enhance the delineation of cardiac injury and functional impairment in TTS patients, assisting in the identification of individuals at higher risk and facilitating the implementation of more targeted and personalized medical therapies. Key points • In TTS, after ventricular recovery, atrial dysfunction persists assessable with CMR feature tracking. • Quantitative assessment of atrial strain discriminates atrial functions: reservoir, conduit, and booster pump. • Atrial booster pump changes after acute TTS, regardless of ventricular function. • Atrial strain may serve as a temporal marker in TTS. Graphical Abstract

show abstract

“…This counteracting effect was more evident in patients with regurgitation biased to the posterior leaflets of the mitral valve, which restricted the diastolic opening of the mitral anterior leaflets. Under some circumstances, it will lead to severe MR, insufficient LV pumping, and myocardial diastolic dysfunction, showing as decreased hoop and longitudinal diastolic strain rates (75). AR increased the risk of poor prognosis in HFpEF patients.…”

Section: Aortic Valve Damages and Hfpefmentioning

confidence: 99%

Different heart failure phenotypes of valvular heart disease: the role of mitochondrial dysfunction

Zhang

Liu

Zhang

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Valvular heart disease (VHD)-related heart failure (HF) is a special subtype of HF with an increasingly concerned heterogeneity in pathophysiology, clinical phenotypes, and outcomes. The mechanism of VHD-related HF involves not only mechanical damage to the valve itself but also valve lesions caused by myocardial ischemia. The interactions between them will lead to the occurrence and development of VHD-related HF subtypes. Due to the spatial (combination of different valvular lesions) and temporal effects (sequence of valvular lesions) of valvular damages, it can make the patient's condition more complicated and also make the physicians deal with a dilemma when deciding on a treatment plan. This indicates that there is still lack of deep understanding on the pathogenic mechanism of VHD-related HF subtypes. On the other hand, mitochondrial dysfunction (MitD) is not only associated with the development of numerous cardiac diseases such as atherosclerosis, hypertension, diabetes, and HF but also occurs in VHD. However, the role of MitD in VHD-related HF is still not fully recognized. In this comprehensive review, we aim to discuss the current findings and challenges of different valvular damages derived from HF subtypes as well as the role of MitD in VHD-related HF subtypes.

show abstract

Impaction of regurgitation jet on anterior mitral leaflet is associated with diastolic dysfunction in patients with bicuspid aortic valve and mild insufficiency: a cardiovascular magnetic resonance study

Cited by 4 publications

References 35 publications

Intra-cardiac pressure drop and flow distribution of bicuspid aortic valve disease in preserved ejection fraction

Intra-cardiac pressure drop and flow distribution of bicuspid aortic valve disease in preserved ejection fraction

Takotsubo syndrome: left atrial and ventricular myocardial strain impairment in the subacute and convalescent phases assessed by CMR

Different heart failure phenotypes of valvular heart disease: the role of mitochondrial dysfunction

Contact Info

Product

Resources

About