See Hooi Ewe1, Marlieke L A Haeck2, Arnold C T Ng3, Tomasz G Witkowski2, Dominique Auger2, Darryl P Leong2, Elena Abate2, Nina Ajmone Marsan2, Eduard R Holman2, Martin J Schalij2, Jeroen J Bax2, Victoria Delgado4. 1. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden 2333ZA, The Netherlands Department of Cardiology, National Heart Centre, Singapore. 2. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden 2333ZA, The Netherlands. 3. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden 2333ZA, The Netherlands Department of Cardiology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia. 4. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden 2333ZA, The Netherlands v.delgado@lumc.nl.
Abstract
AIMS: The aim of this study was to characterize left ventricular (LV) mechanics in symptomatic and asymptomatic patients with moderate-to-severe or severe aortic regurgitation (AR) and preserved ejection fraction (left ventricular ejection fraction) using two-dimensional speckle tracking echocardiography (2D-STE). The association between baseline LV strain and development of indications for surgery in asymptomatic patients was also evaluated. METHODS AND RESULTS: A total of 129 patients with moderate-to-severe or severe AR and LVEF >50% (age 55 ± 17 years, 64% male, 53% asymptomatic at baseline) were included. Standard echocardiography and 2D-STE were performed at baseline. Compared with asymptomatic patients, symptomatic patients had significantly impaired LV longitudinal (-14.9 ± 3.0 vs. -16.8 ± 2.5%, P < 0.001), circumferential (-17.5 ± 2.9 vs. -19.3 ± 2.8%, P = 0.001), and radial (35.7 ± 12.2 vs. 43.1 ± 14.7%, P = 0.004) strains. Among 49 asymptomatic patients who were followed up, 26 developed indications for surgery (symptoms onset or LVEF ≤50%). These patients had comparable LV volumes, LVEF, and colour Doppler assessments of AR jet at baseline, but more impaired LV longitudinal (P = 0.009) and circumferential (P = 0.017) strains compared with patients who remained asymptomatic. Impaired baseline LV longitudinal (per 1% decrease, HR = 1.21, P = 0.04) or circumferential (per 1% decrease, HR = 1.22, P = 0.04) strain was independently associated with the need for surgery. CONCLUSION: Multidirectional LV strain was more impaired in symptomatic than in asymptomatic patients with moderate-to-severe or severe AR, despite preserved LVEF. In asymptomatic AR patients, longitudinal and circumferential strains identified patients who would require surgery during follow-up. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The aim of this study was to characterize left ventricular (LV) mechanics in symptomatic and asymptomatic patients with moderate-to-severe or severe aortic regurgitation (AR) and preserved ejection fraction (left ventricular ejection fraction) using two-dimensional speckle tracking echocardiography (2D-STE). The association between baseline LV strain and development of indications for surgery in asymptomatic patients was also evaluated. METHODS AND RESULTS: A total of 129 patients with moderate-to-severe or severe AR and LVEF >50% (age 55 ± 17 years, 64% male, 53% asymptomatic at baseline) were included. Standard echocardiography and 2D-STE were performed at baseline. Compared with asymptomatic patients, symptomatic patients had significantly impaired LV longitudinal (-14.9 ± 3.0 vs. -16.8 ± 2.5%, P < 0.001), circumferential (-17.5 ± 2.9 vs. -19.3 ± 2.8%, P = 0.001), and radial (35.7 ± 12.2 vs. 43.1 ± 14.7%, P = 0.004) strains. Among 49 asymptomatic patients who were followed up, 26 developed indications for surgery (symptoms onset or LVEF ≤50%). These patients had comparable LV volumes, LVEF, and colour Doppler assessments of AR jet at baseline, but more impaired LV longitudinal (P = 0.009) and circumferential (P = 0.017) strains compared with patients who remained asymptomatic. Impaired baseline LV longitudinal (per 1% decrease, HR = 1.21, P = 0.04) or circumferential (per 1% decrease, HR = 1.22, P = 0.04) strain was independently associated with the need for surgery. CONCLUSION: Multidirectional LV strain was more impaired in symptomatic than in asymptomatic patients with moderate-to-severe or severe AR, despite preserved LVEF. In asymptomatic AR patients, longitudinal and circumferential strains identified patients who would require surgery during follow-up. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Covadonga Fernández-Golfín; Rocío Hinojar-Baydes; Ariana González-Gómez; Juan Manuel Monteagudo; Amparo Esteban; Gonzalo Alonso-Salinas; Maria Angeles Fernández; Ana García-Martín; Ciro Santoro; Marina Pascual-Izco; Jose Julio Jiménez-Nacher; Jose Luis Zamorano Journal: Eur Radiol Date: 2021-01-15 Impact factor: 5.315
Authors: Roxana Enache; Bogdan A Popescu; Rita Piazza; Denisa Muraru; Andreea Călin; Carmen C Beladan; Monica Roşca; Gian Luigi Nicolosi; Carmen Ginghină Journal: Int J Cardiovasc Imaging Date: 2015-05-21 Impact factor: 2.357
Authors: Abraham Sonny; Andrej Alfirevic; Shiva Sale; Nicole M Zimmerman; Jing You; A Marc Gillinov; Daniel I Sessler; Andra E Duncan Journal: Anesth Analg Date: 2018-05 Impact factor: 5.108
Authors: E Mara Vollema; Gurpreet K Singh; Edgard A Prihadi; Madelien V Regeer; See Hooi Ewe; Arnold C T Ng; Bart J A Mertens; Robert J M Klautz; Nina Ajmone Marsan; Jeroen J Bax; Victoria Delgado Journal: Eur Heart J Cardiovasc Imaging Date: 2019-10-01 Impact factor: 6.875
Authors: Radka Kočková; Hana Línková; Zuzana Hlubocká; Alena Pravečková; Andrea Polednová; Lucie Súkupová; Martin Bláha; Jiří Malý; Eva Honsová; David Sedmera; Martin Pěnička Journal: J Clin Med Date: 2019-10-11 Impact factor: 4.241