Brian R Lindman1, Qi Liu2, Brian P Cupps3, Pamela K Woodard4, Eric Novak5, Anna M Vatterott5, Danielle J Koerner3, Kevin Kulshrestha3, Michael K Pasque3. 1. Vanderbilt University Medical Center, Nashville, Tennessee. 2. Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York. 3. Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri. 4. Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri. 5. Division of Cardiovascular, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
Abstract
BACKGROUND AND AIM: Left ventricular (LV) systolic strain has been shown to be an early marker of LV dysfunction in patients with severe aortic stenosis (AS) despite preserved ejection fraction (EF). Echocardiography has provided useful data on regional LV strain patterns, but is not as sensitive as magnetic resonance imaging (MRI). No prior studies have used MRI-based strain analysis to characterize regional three-dimensional strain in patients with severe AS. METHODS: Twelve patients with severe AS and preserved EF underwent MRI-based multiparametric strain analysis. Circumferential and longitudinal strain values were calculated at individual points throughout the LV and analyzed in 12 discrete regions. Strain values were compared to a database of normal controls. RESULTS: Compared to control patients, circumferential strain in AS patients was significantly reduced at the base (P = 0.002), mid (P = 0.042), and inferior walls (P < 0.001). Longitudinal strain was significantly reduced at the base (P < 0.001), mid (P < 0.001), anterior (P < 0.001), and septal (P < 0.001) walls. Among patients with AS, there was heterogeneity in the location and severity of abnormalities in circumferential and longitudinal strains despite the presence of a preserved EF and lack of prior myocardial infarction. CONCLUSIONS: LV systolic strain is significantly impaired in patients with AS and preserved EF compared to healthy volunteers. Abnormalities in circumferential and longitudinal strains were heterogeneously distributed across the LV of patients with AS, allowing us to identify sentinel regions that may reflect the earliest signs of developing LV dysfunction.
BACKGROUND AND AIM: Left ventricular (LV) systolic strain has been shown to be an early marker of LV dysfunction in patients with severe aortic stenosis (AS) despite preserved ejection fraction (EF). Echocardiography has provided useful data on regional LV strain patterns, but is not as sensitive as magnetic resonance imaging (MRI). No prior studies have used MRI-based strain analysis to characterize regional three-dimensional strain in patients with severe AS. METHODS: Twelve patients with severe AS and preserved EF underwent MRI-based multiparametric strain analysis. Circumferential and longitudinal strain values were calculated at individual points throughout the LV and analyzed in 12 discrete regions. Strain values were compared to a database of normal controls. RESULTS: Compared to control patients, circumferential strain in AS patients was significantly reduced at the base (P = 0.002), mid (P = 0.042), and inferior walls (P < 0.001). Longitudinal strain was significantly reduced at the base (P < 0.001), mid (P < 0.001), anterior (P < 0.001), and septal (P < 0.001) walls. Among patients with AS, there was heterogeneity in the location and severity of abnormalities in circumferential and longitudinal strains despite the presence of a preserved EF and lack of prior myocardial infarction. CONCLUSIONS: LV systolic strain is significantly impaired in patients with AS and preserved EF compared to healthy volunteers. Abnormalities in circumferential and longitudinal strains were heterogeneously distributed across the LV of patients with AS, allowing us to identify sentinel regions that may reflect the earliest signs of developing LV dysfunction.
Authors: Rafael García Fuster; José A Montero Argudo; Oscar Gil Albarova; Fernando Hornero Sos; Sergio Cánovas López; Ma José Dalmau Sorlí; María Bueno Codoñer; José A Buendía Miñano Journal: Eur J Cardiothorac Surg Date: 2003-05 Impact factor: 4.191
Authors: Andrew K Knutsen; Ningning Ma; Ajay K Taggar; Beckah D Brady; Brian P Cupps; Michael K Pasque Journal: Ann Thorac Surg Date: 2012-03-03 Impact factor: 4.330
Authors: Patrizio Lancellotti; Erwan Donal; Julien Magne; Kim O'Connor; Marie L Moonen; Bernard Cosyns; Luc A Pierard Journal: Eur J Echocardiogr Date: 2010-03-04
Authors: Brian P Cupps; Douglas R Bree; Jason R Wollmuth; Analyn C Howells; Rochus K Voeller; Joseph G Rogers; Michael K Pasque Journal: Ann Thorac Surg Date: 2008-11 Impact factor: 4.330
Authors: Pavlos Moustakidis; Brian P Cupps; Benjamin J Pomerantz; Randall P Scheri; Hersh S Maniar; Andrew M Kates; Robert J Gropler; Michael K Pasque; Thoralf M Sundt Journal: J Surg Res Date: 2004-02 Impact factor: 2.192
Authors: Jordi S Dahl; Lars Videbæk; Mikael K Poulsen; Torsten R Rudbæk; Patricia A Pellikka; Jacob E Møller Journal: Circ Cardiovasc Imaging Date: 2012-08-06 Impact factor: 7.792
Authors: Wilfried Dinh; Werner Nickl; Jan Smettan; Frank Kramer; Thomas Krahn; Thomas Scheffold; Michael Coll Barroso; Hilmar Brinkmann; Till Koehler; Mark Lankisch; Reiner Füth Journal: Cardiovasc Ultrasound Date: 2010-07-26 Impact factor: 2.062
Authors: Christian Basile; Ilaria Fucile; Maria Lembo; Maria Virginia Manzi; Federica Ilardi; Anna Franzone; Costantino Mancusi Journal: J Clin Med Date: 2021-11-26 Impact factor: 4.241
Authors: F Hardt; M Becker; V Brandenburg; J Grebe; T Dirrichs; R F Gohmann; K Fehrenbacher; J Schmoee; S D Reinartz Journal: PLoS One Date: 2020-03-02 Impact factor: 3.240