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Erschienen in: The International Journal of Cardiovascular Imaging 1/2021

04.09.2020 | Original Paper

Are there any subclinical myocardial dysfunctions in subjects with aortic valve sclerosis? A 3D-speckle tracking echocardiography study

verfasst von: Mustafa Dogdus, Arafat Yildirim, Mehmet Kucukosmanoglu, Salih Kilic, Oguz Yavuzgil, Sanem Nalbantgil

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 1/2021

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Abstract

Aortic valve sclerosis (AVS) is defined as calcified and thickened aortic leaflets without restriction of leaflet motion. We have not found any studies that previously assessed the effect of AVS on myocardial functions with three dimensional-speckle tracking echocardiography (3D-STE). Therefore, we aimed to identify any early changes in left atrial (LA) myocardial dynamics and/or left ventricular (LV) systolic functions in patients with AVS using 3D-STE. Seventy-five patients with AVS and 80 age- and gender-matched controls were enrolled into the study. The baseline clinical characteristics of the study patients were recorded. Conventional 2D echocardiographic and 3D-STE analyses were performed. The LV-global longitudinal strain (LV-GLS) and LV-global circumferential strain (LV-GCS) were significantly decreased in the AVS (+) group than in the control group (p < 0.001 and p = 0.013, respectively). In multivariate logistic regression analysis; LV-GLS (p < 0.001, odds ratio (OR) = 3.16, 95% confidence interval (CI) 1.42–5.63) and Triglyceride (TG) (p = 0.033, OR = 1.29, 95% CI 1.11–1.72) were found to be independent predictors of AVS. ROC analysis was performed to find out the ideal LV-GLS cut-off value for predicting the AVS. A LV-GLS value of > − 18 has 85.8% sensitivity, 67.5% specificity for the prediction of the AVS. Our results support that subjects with AVS may have subclinical LV deformation abnormalities even though they have not LV pressure overload. According to our findings, patients with AVS should be investigated in terms of atherosclerotic risk factors, their dysmetabolic status should be evaluated and closely followed up for their progression to calcific aortic stenosis.
Literatur
1.
Zurück zum Zitat Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS (1999) Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly. N Engl J Med 341:142–147CrossRef Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS (1999) Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly. N Engl J Med 341:142–147CrossRef
2.
Zurück zum Zitat Poggio P, Branchetti E, Grau JB, Lai EK, Gorman RC, Gorman JH et al (2014) Osteopontin-CD44v6 interaction mediates calcium deposition via phospho-Akt in valve interstitial cells from patients with noncalcified aortic valve sclerosis. Arterioscler Thromb Vasc Biol 34:2086–2094CrossRef Poggio P, Branchetti E, Grau JB, Lai EK, Gorman RC, Gorman JH et al (2014) Osteopontin-CD44v6 interaction mediates calcium deposition via phospho-Akt in valve interstitial cells from patients with noncalcified aortic valve sclerosis. Arterioscler Thromb Vasc Biol 34:2086–2094CrossRef
3.
Zurück zum Zitat Otto CM, Kuusisto J, Reichenbach DD, Gown AM, O’Brien KD (1994) Characterization of the early lesion of ‘degenerative’ valvular aortic stenosis. Histological and immunohistochemical studies. Circulation 90:844–853CrossRef Otto CM, Kuusisto J, Reichenbach DD, Gown AM, O’Brien KD (1994) Characterization of the early lesion of ‘degenerative’ valvular aortic stenosis. Histological and immunohistochemical studies. Circulation 90:844–853CrossRef
4.
Zurück zum Zitat Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE et al (1997) Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study J Am Coll Cardiol 29:630–634CrossRef Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE et al (1997) Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study J Am Coll Cardiol 29:630–634CrossRef
5.
Zurück zum Zitat Boon A, Cheriex E, Lodder J, Kessels F (1997) Cardiac valve calcification: characteristics of patients with calcification of the mitral annulus or aortic valve. Heart 78(5):472–474CrossRef Boon A, Cheriex E, Lodder J, Kessels F (1997) Cardiac valve calcification: characteristics of patients with calcification of the mitral annulus or aortic valve. Heart 78(5):472–474CrossRef
6.
Zurück zum Zitat Chandra HR, Goldstein JA, Choudhary N, O’Neill CS, George PB, Gangasani SR et al (2004) Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation. J Am Coll Cardiol 43:169–175CrossRef Chandra HR, Goldstein JA, Choudhary N, O’Neill CS, George PB, Gangasani SR et al (2004) Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation. J Am Coll Cardiol 43:169–175CrossRef
7.
Zurück zum Zitat Shah SJ, Ristow B, Ali S, Na BY, Schiller NB, Whooley MA (2007) Acute myocardial infarction in patients with versus without aortic valve sclerosis and effect of statin therapy (from the Heart and Soul Study). Am J Cardiol 99(8):1128–1133CrossRef Shah SJ, Ristow B, Ali S, Na BY, Schiller NB, Whooley MA (2007) Acute myocardial infarction in patients with versus without aortic valve sclerosis and effect of statin therapy (from the Heart and Soul Study). Am J Cardiol 99(8):1128–1133CrossRef
8.
Zurück zum Zitat Aronow WS, Ahn C, Shirani J, Kronzon I (1999) Comparison of frequency of new coronary events in older subjects with and without valvular aortic sclerosis. Am J Cardiol 83:599–600CrossRef Aronow WS, Ahn C, Shirani J, Kronzon I (1999) Comparison of frequency of new coronary events in older subjects with and without valvular aortic sclerosis. Am J Cardiol 83:599–600CrossRef
9.
Zurück zum Zitat Gharacholou SM, Karon BL, Shub C, Pellikka PA (2011) Aortic valve sclerosis and clinical outcomes: moving toward a definition. Am J Med 124:103–110CrossRef Gharacholou SM, Karon BL, Shub C, Pellikka PA (2011) Aortic valve sclerosis and clinical outcomes: moving toward a definition. Am J Med 124:103–110CrossRef
10.
Zurück zum Zitat Kleijn SA, Aly MF, Terwee CB, van Rossum AC, Kamp O (2011) Comparison between direct volumetric and speckle tracking methodologies for left ventricular and left atrial chamber quantification by three-dimensional echocardiography. Am J Cardiol 108:1038–1044CrossRef Kleijn SA, Aly MF, Terwee CB, van Rossum AC, Kamp O (2011) Comparison between direct volumetric and speckle tracking methodologies for left ventricular and left atrial chamber quantification by three-dimensional echocardiography. Am J Cardiol 108:1038–1044CrossRef
11.
Zurück zum Zitat Mochizuki A, Yuda S, Oi Y, Kawamukai M, Nishida J, Kouzu H et al (2013) Assessment of left atrial deformation and synchrony by three-dimensional speckle-tracking echocardiography: comparative studies in healthy subjects and patients with atrial fibrillation. J Am Soc Echocardiogr 26:165–174CrossRef Mochizuki A, Yuda S, Oi Y, Kawamukai M, Nishida J, Kouzu H et al (2013) Assessment of left atrial deformation and synchrony by three-dimensional speckle-tracking echocardiography: comparative studies in healthy subjects and patients with atrial fibrillation. J Am Soc Echocardiogr 26:165–174CrossRef
12.
Zurück zum Zitat Nemes A, Domsik P, Kalapos A, Lengyel C, Orosz A, Forster T (2014) Comparison of three-dimensional speckle tracking echocardiography and two-dimensional echocardiography for evaluation of left atrial size and function in healthy volunteers (results from the MAGYAR Healthy Study). Echocardiography 31:865–871PubMed Nemes A, Domsik P, Kalapos A, Lengyel C, Orosz A, Forster T (2014) Comparison of three-dimensional speckle tracking echocardiography and two-dimensional echocardiography for evaluation of left atrial size and function in healthy volunteers (results from the MAGYAR Healthy Study). Echocardiography 31:865–871PubMed
13.
Zurück zum Zitat Lang RM, Badano LP, Tsang W, Adams DH, Agricola E, Buck T et al (2012) American Society of Echocardiography; European Association of Echocardiography. EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography. J Am Soc Echocardiogr 25:3–46CrossRef Lang RM, Badano LP, Tsang W, Adams DH, Agricola E, Buck T et al (2012) American Society of Echocardiography; European Association of Echocardiography. EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography. J Am Soc Echocardiogr 25:3–46CrossRef
14.
Zurück zum Zitat Sugimoto T, Robinet S, Dulgheru R, Bernard A, Ilardi F, Contu L et al (2018) Echocardiographic reference ranges for normal left atrial function parameters: results from the EACVI NORRE study. Eur Heart J Cardiovasc Imaging 19(6):630–638CrossRef Sugimoto T, Robinet S, Dulgheru R, Bernard A, Ilardi F, Contu L et al (2018) Echocardiographic reference ranges for normal left atrial function parameters: results from the EACVI NORRE study. Eur Heart J Cardiovasc Imaging 19(6):630–638CrossRef
15.
Zurück zum Zitat Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ et al (2017) 2017 ESC/EACTS Guidelines for the management of valvular heart disease. The task force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 38:2739–2791CrossRef Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ et al (2017) 2017 ESC/EACTS Guidelines for the management of valvular heart disease. The task force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 38:2739–2791CrossRef
16.
Zurück zum Zitat Novo G, Fazio G, Visconti C, Carità P, Maira E, Fattouch K et al (2011) Atherosclerosis, degenerative aortic stenosis and statins. Curr Drug Targets 12:115–121CrossRef Novo G, Fazio G, Visconti C, Carità P, Maira E, Fattouch K et al (2011) Atherosclerosis, degenerative aortic stenosis and statins. Curr Drug Targets 12:115–121CrossRef
17.
Zurück zum Zitat Freeman RV, Otto CM (2005) Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies. Circulation 111:3316–3326CrossRef Freeman RV, Otto CM (2005) Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies. Circulation 111:3316–3326CrossRef
18.
Zurück zum Zitat Amzulescu MS, De Craene M, Langet H, Pasquet A, Vancraeynest D, Pouleur AC et al (2019) Myocardial strain imaging: review of general principles, validation, and sources of discrepancies. Eur Heart J Cardiovasc Imaging 20:605–619CrossRef Amzulescu MS, De Craene M, Langet H, Pasquet A, Vancraeynest D, Pouleur AC et al (2019) Myocardial strain imaging: review of general principles, validation, and sources of discrepancies. Eur Heart J Cardiovasc Imaging 20:605–619CrossRef
19.
Zurück zum Zitat Mizuguchi Y, Oishi Y, Miyoshi H, Iuchi A, Nagase N, Oki T (2008) The functional role of longitudinal, circumferential, and radial myocardial deformation for regulating the early impairment of left ventricular contraction and relaxation in patients with cardiovascular risk factors: a study with twodimensional strain imaging. J Am Soc Echocardiogr 21:1138–1144CrossRef Mizuguchi Y, Oishi Y, Miyoshi H, Iuchi A, Nagase N, Oki T (2008) The functional role of longitudinal, circumferential, and radial myocardial deformation for regulating the early impairment of left ventricular contraction and relaxation in patients with cardiovascular risk factors: a study with twodimensional strain imaging. J Am Soc Echocardiogr 21:1138–1144CrossRef
20.
Zurück zum Zitat Dusenbery SM, Lunze FI, Jerosch-Herold M, Geva T, Newburger JW, Colan SD et al (2015) Left ventricular strain and myocardial fibrosis in congenital aortic stenosis. Am J Cardiol 116:1257–1262CrossRef Dusenbery SM, Lunze FI, Jerosch-Herold M, Geva T, Newburger JW, Colan SD et al (2015) Left ventricular strain and myocardial fibrosis in congenital aortic stenosis. Am J Cardiol 116:1257–1262CrossRef
21.
Zurück zum Zitat Weidemann F, Herrmann S, Stork S, Niemann M, Frantz S, Lange V et al (2009) Impact of myocardial fibrosis in patients with symptomatic severe aortic stenosis. Circulation 120:577–584CrossRef Weidemann F, Herrmann S, Stork S, Niemann M, Frantz S, Lange V et al (2009) Impact of myocardial fibrosis in patients with symptomatic severe aortic stenosis. Circulation 120:577–584CrossRef
22.
Zurück zum Zitat Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK et al (2007) Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 49:403–414CrossRef Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK et al (2007) Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 49:403–414CrossRef
23.
Zurück zum Zitat Katz R, Wong ND, Kronmal R, Takasu J, Shavelle DM, Probstfield JL et al (2006) Features of the metabolic syndrome and diabetes mellitus as predictors of aortic valve calcification in the Multi-Ethnic Study of Atherosclerosis. Circulation 113:2113–2119CrossRef Katz R, Wong ND, Kronmal R, Takasu J, Shavelle DM, Probstfield JL et al (2006) Features of the metabolic syndrome and diabetes mellitus as predictors of aortic valve calcification in the Multi-Ethnic Study of Atherosclerosis. Circulation 113:2113–2119CrossRef
24.
Zurück zum Zitat Katz R, Budoff MJ, Takasu J, Shavelle DM, Bertoni A, Blumenthal RS et al (2009) Relationship of metabolic syndrome to incident aortic valve calcium and aortic valve calcium progression: the Multi-Ethnic Study of Atherosclerosis. Diabetes 58:813–819CrossRef Katz R, Budoff MJ, Takasu J, Shavelle DM, Bertoni A, Blumenthal RS et al (2009) Relationship of metabolic syndrome to incident aortic valve calcium and aortic valve calcium progression: the Multi-Ethnic Study of Atherosclerosis. Diabetes 58:813–819CrossRef
25.
Zurück zum Zitat Briand M, Lemieux I, Dumesnil JG, Mathieu P, Cartier A, Després JP et al (2006) Metabolic syndrome negatively influences disease progression and prognosis in aortic stenosis. J Am Coll Cardiol 47:2229–2237CrossRef Briand M, Lemieux I, Dumesnil JG, Mathieu P, Cartier A, Després JP et al (2006) Metabolic syndrome negatively influences disease progression and prognosis in aortic stenosis. J Am Coll Cardiol 47:2229–2237CrossRef
26.
Zurück zum Zitat Capoulade R, Clavel MA, Dumesnil JG, Chan KL, Teo KK, Tam JW et al (2012) Impact of metabolic syndrome on progression of aortic stenosis: influence of age and statin therapy. J Am Coll Cardiol 60(3):216–223CrossRef Capoulade R, Clavel MA, Dumesnil JG, Chan KL, Teo KK, Tam JW et al (2012) Impact of metabolic syndrome on progression of aortic stenosis: influence of age and statin therapy. J Am Coll Cardiol 60(3):216–223CrossRef
27.
Zurück zum Zitat Utsunomiya H, Yamamoto H, Kunita E, Hidaka T, Kihara Y (2014) Insulin resistance and subclinical abnormalities of global and regional left ventricular function in patients with aortic valve sclerosis. Cardiovasc Diabetol 13:86CrossRef Utsunomiya H, Yamamoto H, Kunita E, Hidaka T, Kihara Y (2014) Insulin resistance and subclinical abnormalities of global and regional left ventricular function in patients with aortic valve sclerosis. Cardiovasc Diabetol 13:86CrossRef
Metadaten
Titel
Are there any subclinical myocardial dysfunctions in subjects with aortic valve sclerosis? A 3D-speckle tracking echocardiography study
verfasst von
Mustafa Dogdus
Arafat Yildirim
Mehmet Kucukosmanoglu
Salih Kilic
Oguz Yavuzgil
Sanem Nalbantgil
Publikationsdatum
04.09.2020
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 1/2021
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-020-01977-4

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