Myocardial deformation in aortic valve stenosis: relation to left ventricular geometry

Cramariuc, Dana; Gerdts, Eva; Davidsen, Einar Skulstad; Segadal, Leidulf; Matre, Knut

doi:10.1136/hrt.2009.172569

Cited by 125 publications

(97 citation statements)

References 34 publications

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“…Younan et al [18] showed a negative correlation of GLS with LVMI. Similar results were obtained by Cramariuc et al [19]. In the study by Dinh et al [20] GLS correlated with a degree of LV hypertrophy assessed by magnetic resonance imaging and was significantly worse in groups of patients with a greater degree of hypertrophy.…”

Section: Discussionsupporting

confidence: 78%

Exercise-induced changes in left ventricular global longitudinal strain in asymptomatic severe aortic stenosis

et al. 2017

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A b s t r a c t Background:The management of patients with asymptomatic severe aortic stenosis (ASAS) is still under discussion. Therefore, it is advisable to search for the parameters of early damage to left ventricular (LV) function. Aim:The aim of the study was to assess exercise-induced changes in LV global longitudinal strain (GLS) in ASAS. Methods:The ASAS group consisted of 50 patients (26 women and 24 men, aged 38.4 ± 18.1 years) meeting the echocardiographic criteria of severe aortic stenosis (AVA < 1 cm 2 , AVAI < 0.6 cm 2 /m 2 , Vmax > 4 m/s, mean aortic gradient > 40 mm Hg), with normal LV ejection fraction (LVEF ≥ 55%) and sinus rhythm on electrocardiogram, and without significant concomitant valvular heart diseases. The control group consisted of 21 people matched for age and sex. Echocardiographic examinations and echocardiographic stress tests with the assessment of GLS using the speckle tracking imaging were performed. Results:The ASAS group was characterised by statistically significantly higher LV mass index (LVMI) and higher LVEF. GLS values at rest in both groups were within normal limits but were significantly higher in the control group (-18.9 ± 2.4% vs. -20.7 ± 1.7%, p = 0.006). An increase in GLS at peak exercise in both groups was observed, lower in the ASAS group (the difference was not statistically significant: -0.8 ± 3.0% vs. -2.2 ± 3.1%, p = 0.086). Changes in GLS during exercise (∆GLS) did not correlate with the parameters of the severity of aortic stenosis. In the multivariate model, LVMI proved to be a factor associated with GLS at rest and during exercise. Conclusions:In patients with ASAS, GLS is a non-invasive marker of an early stage of LV myocardial damage associated with myocardial hypertrophy. An increase in GLS during exercise in the ASAS group, smaller than in the control group, indicates a preserved functional reserve of the LV myocardium but smaller than in healthy individuals. The assessment of the clinical usefulness of exercise-induced changes in GLS requires further research.

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Section: Discussionsupporting

confidence: 78%

Exercise-induced changes in left ventricular global longitudinal strain in asymptomatic severe aortic stenosis

et al. 2017

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“…[16][17][18] Furthermore, these parameters have been shown to be superior to LVEF to predict adverse outcomes in AS. [16][17][18][19][20] From a pathophysiological standpoint, these data are consistent with the concept that the increase in wall stress and intra-myocardial pressure as well as the reduction in M A N U S C R I P T…”

Section: Amount and Distribution Of Adiposity Versus LV Systolic Dysfsupporting

confidence: 75%

Visceral Adiposity and Left Ventricular Mass and Function in Patients With Aortic Stenosis: The PROGRESSA Study

Capoulade

Larose

Mathieu

et al. 2014

Canadian Journal of Cardiology

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Brief SummaryThe purpose of this study was to examine the association between amount and distribution of body fat and LV hypertrophy and systolic dysfunction in aortic stenosis (AS) patients. The increased total adiposity as well as a high proportion of visceral adipose tissue (VAT) are both associated with LV hypertrophy, independent of AS severity and hypertension. The excess VAT and a high proportion of VAT relative to total adipose tissue are independently associated with impaired LV systolic function in AS. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3 ABSTRACTBackground: Recent studies have reported that obesity, metabolic syndrome, and diabetes are

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“…Several studies have demonstrated that GLS $215% should be considered pathologic (21)(22)(23). Therefore, we defined the cutoff point of GLS as 215%.…”

Section: Evaluation Of Cardiac Functionsmentioning

confidence: 99%

Association of Left Ventricular Longitudinal Strain with Mortality among Stable Hemodialysis Patients with Preserved Left Ventricular Ejection Fraction

Liu¹,

Sung

et al. 2013

Clinical Journal of the American Society of Nephrology

101

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SummaryBackground and objectives Little is known about the optimal echocardiographic parameters for risk stratification in stable dialysis patients with preserved left ventricular ejection fraction (LVEF) (ejection fraction $50%). Left ventricular (LV) global peak systolic longitudinal strain (GLS) is the ratio of the maximal change in myocardial longitudinal length in systole to the original length and reliably and accurately assesses LV function. During systole, LV myocardium in the longitudinal direction shortens and GLS is represented by a negative value. The more negative value of GLS, the better the LV function is. This study hypothesized that subtle abnormalities of GLS are associated with an adverse prognosis.Design, setting, participants, & measurements This prospective study collected clinical and echocardiographic data (including GLS) from 88 stable hemodialysis patients (mean age 67.0611.2 years; 35% men) with preserved LVEF. These patients were enrolled from December 2008 to January 2009 and were followed-up for 25.669.9 months. The primary outcome was all-cause mortality. Multivariate Cox regression analysis was used to investigate risk factors for mortality.Results The mortality group (n=24) had lower albumin levels, less negative GLS, and higher prevalence of coronary artery disease and diabetes mellitus than the survival group. Using a GLS cutoff value of 215%, the less negative GLS group (GLS $215%) had a higher mortality rate. Cox regression analyses revealed that lower albumin level (hazard ratio, 0.16; 95% confidence interval, 0.05 to 0.53; P=0.003) and less negative GLS (hazard ratio, 3.57; 95% confidence interval, 1.41 to 9.04; P=0.01) were independent predictors of all-cause mortality. Furthermore, less negative GLS was associated with a higher cardiovascular death rate.Conclusions Less negative GLS is predictive of poor prognosis among stable hemodialysis patients with preserved LVEF.

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Myocardial deformation in aortic valve stenosis: relation to left ventricular geometry

Cited by 125 publications

References 34 publications

Exercise-induced changes in left ventricular global longitudinal strain in asymptomatic severe aortic stenosis

Exercise-induced changes in left ventricular global longitudinal strain in asymptomatic severe aortic stenosis

Visceral Adiposity and Left Ventricular Mass and Function in Patients With Aortic Stenosis: The PROGRESSA Study

Association of Left Ventricular Longitudinal Strain with Mortality among Stable Hemodialysis Patients with Preserved Left Ventricular Ejection Fraction

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