Sequential changes in myocardial function after valve replacement for aortic stenosis by speckle tracking echocardiography

Rost, Christian; Korder, S.; Wasmeier, Gerald; Wu, M. H.; Klinghammer, Lutz; Flachskampf, Frank A.; Daniel, Werner G.; Voigt, Jens‐Uwe

doi:10.1093/ejechocard/jeq017

Cited by 51 publications

(40 citation statements)

References 18 publications

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“…In our patients, the compensated group exhibited values above the cutoff point, whereas in the decompensated group with and without CAD, values were 13.5% and 13.6%, respectively. Other authors demonstrated that SGLS returned to normal values at 1 year post valve replacement [44]; in our study SGLS values returned to normal only in the compensated group (Table 2).…”

Section: Discussionsupporting

confidence: 55%

Severe aortic stenosis with preserved ejection fraction and evidence of impairment in structure, myocardial strain and ventricular function: A new contribution to clinical decision making

et al. 2015

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Background: Left ventricular ejection fraction (LVEF) is among the parameters that are usually employed to define surgical timing of severe aortic stenosis (AS G1: 328 ± 66, G2a: 376 ± 22, G2b: 385 ± 13, p < 0.01; collagen volume [%]: G1: 4.77 ± 1.27, G2a: 8.40 ± 1.27, G2b: 11.05 ± 3.08, p < 0.01; LVEDP normalized by diastolic diameter [mm Hg/mm]: G1: 0.27 ± 0.01, G2a: 0.39 ± 0.06, G2b: 0.44 ± 0.11, p < 0.02; +dP/dt max /LVEDP [mm Hg/s/mm Hg]: G1: 176 ± 45, G2a: 89.6 ± 20, G2b: 113.1 ± 41, p < 0.01; p < 0.05 (Cardiol J 2015; 22, 6: 613-621)

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Section: Discussionsupporting

confidence: 55%

Severe aortic stenosis with preserved ejection fraction and evidence of impairment in structure, myocardial strain and ventricular function: A new contribution to clinical decision making

et al. 2015

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“…However, significant amelioration also occurred in the apical segments after 12 months, which indicates constant long-term recovery of systolic function from the basis to the apex. 31 In addition, we detected regression of LVM, which further indicates favourable reverse remodelling. 31 …”

Section: Discussion Systolic Functionsupporting

confidence: 52%

“…31 In addition, we detected regression of LVM, which further indicates favourable reverse remodelling. 31 …”

Section: Discussion Systolic Functionsupporting

confidence: 52%

Recovery of left ventricular and left atrial mechanics in various entities of aortic stenosis 12 months after TAVI

Spethmann

Baldenhofer

Dreger

et al. 2013

European Heart Journal - Cardiovascular Imaging

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BackgroundTranscatheter aortic valve implantation (TAVI) has been shown to improve prognosis of high-risk patients. Data, however, concerning the impact of TAVI on regional and global left atrial (LA) and left ventricular (LV) mechanics in varying entities of severe aortic stenosis (AS) are sparse, particularly in patients with paradoxical low-flow (PLF) AS or with reduced LV ejection fraction (LVEF). This study evaluated the effects of TAVI on LA and LV mechanics in varying entities of AS 12 months after implantation. Methods and resultsA total of 54 consecutive patients with severe AS (24 with a normal LVEF and normal flow, 16 with PLF, and 14 with a reduced LVEF) were included. Speckle tracking echocardiography was performed before and 12 months after TAVI to determine LV global and regional longitudinal deformation as well as LA function (reservoir function, conduit phase, and active contraction). In all the three entities of AS, there was a significant improvement in global and regional LV longitudinal function (average global longitudinal strain: 214.1 + 3.9% at baseline vs. 216.5 + 4.0% after TAVI, P , 0.001). Interestingly, the beneficial effects were most pronounced in patients with PLF (214.0 + 2.9 vs. 217.0 + 4.4%, P , 0.031). Moreover, the atrial reservoir and conduit function recovered significantly after TAVI in all patients. ConclusionIn conclusion, regardless of the underlying AS entity, TAVI improves global and regional LV and LA mechanics within 12 months.--

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“…21,25,26) Interestingly, LSr decreased 6 months earlier than RSr, although LVEF was preserved during the one-year observation period. 21) Vinereaunu, et al suggested that a progressive decline in longitudinal systolic function is closely associated with global diastolic function, and the augmentation or preservation of radial contraction maintains normal ejection fraction.…”

Section: -7)mentioning

confidence: 91%

Patterns of Decrease in Multidirectional Myocardial Deformations in Patients With Fluctuating Left Ventricular Ejection Fraction

et al. 2014

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SummaryFew studies have examined the variations in longitudinal/circumferential/radial strain (LS/CS/RS) and strain rate (LSr/CSr/RSr) in individual hearts when the left ventricular ejection fraction (LVEF) has changed. We hypothesized the relationships of strain/strain rate and LVEF are not linear, but vary with multiple inflection points (IPs) in individual hearts.Twenty-five patients with fluctuating LVEF (ΔLVEF > 10%) who had 2-D speckle tracking echocardiography available for analysis were enrolled. After models of best fit were obtained from the 'collective' plots to determine inflection points, the decrements of slopes above inflection points (IP) were compared with those below IPs in the 'individual hearts' plots.In the 'collective' plots, both LS and LSr linearly decreased in proportion to LVEF when LVEF ≥ 40% but remained constant regardless of LVEF when LVEF < 40% (IPs when LVEF = 40%, P < 0.0001). The RS-LVEF relationship was sigmoid with two IPs when LVEF = 30% and 50% (P < 0.0001). However, in the 'individual hearts' plots, the decrements of slopes above and below IPs were not different for LS-LVEF and LSr-LVEF, and marginally different for RS-LVEF (P = 0.049, across IP when LVEF = 50%).Collectively, the relationship of LS/LSr/RS and LVEF seemed to be not linear, but inflective, however, we could not prove the inflective relationship in individual hearts with fluctuating LVEF. Further study with more patients is needed to prove our hypothesis. (Int Heart J 2014; 55: 319-325) Key words: Heart failure, Myocardial strain, Strain rate imaging L eft ventricular (LV) systolic work is produced by a combination of the following 3-dimensional myocardial deformations: longitudinal, circumferential and radial strain.Longitudinal strain and strain rate can be measured by Doppler tissue velocity imaging (TVI), which seems superior to conventional echocardiographic parameters at predicting LV systolic dysfunction in various cardiac diseases. 1-3)Since the introduction of 2-dimensional speckle tracking echocardiography (2DSTE) to the field of cardiac imaging, radial and circumferential strain can be analyzed in addition to longitudinal strain. Furthermore, early detection of ischemic heart disease and various cardiomyopathies is now feasible with 2DSTE. 4-7)Despite these advances, the variations in multidirectional myocardial deformations in individual hearts with fluctuating LV systolic function have not yet been fully elucidated.We previously described a different pattern of multidirectional impairment in doxorubicin-induced cardiomyopathy models in rats, 8) and tried to prove a similar pattern of impairment in human subjects in the current study, by investigating functional changes in each LV axis by analyzing longitudinal/ circumferential/radial strain (LS/CS/RS) and strain rate (LSr/ CSr/RSr) of LV with fluctuating LVEF.We also hypothesized the decrements in strain and strain rate are not constant but inflective as LVEF decreases, and the patterns of decrease in longitudinal strain/strain rate are different ...

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Sequential changes in myocardial function after valve replacement for aortic stenosis by speckle tracking echocardiography

Cited by 51 publications

References 18 publications

Severe aortic stenosis with preserved ejection fraction and evidence of impairment in structure, myocardial strain and ventricular function: A new contribution to clinical decision making

Severe aortic stenosis with preserved ejection fraction and evidence of impairment in structure, myocardial strain and ventricular function: A new contribution to clinical decision making

Recovery of left ventricular and left atrial mechanics in various entities of aortic stenosis 12 months after TAVI

Patterns of Decrease in Multidirectional Myocardial Deformations in Patients With Fluctuating Left Ventricular Ejection Fraction

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