Skip to main content
Erschienen in: Pediatric Cardiology 5/2013

01.06.2013 | Original Article

Strain and Strain Rate Echocardiography Findings in Children With Asymptomatic Congenital Aortic Stenosis

verfasst von: Vehbi Dogan, Burhan Öcal, Utku Arman Orun, Senem Ozgur, Osman Yılmaz, Mahmut Keskin, Özben Ceylan, Selmin Karademir, Filiz Şenocak

Erschienen in: Pediatric Cardiology | Ausgabe 5/2013

Einloggen, um Zugang zu erhalten

Abstract

The aim of our study was to evaluate myocardial functions with strain/strain rate echocardiography in asymptomatic patients having congenital aortic stenosis (CAS) with normal cardiac functions as determined by conventional echocardiographic techniques and comparing them with those of healthy controls. A total of 58 patients with various degrees of isolated CAS and 52 healthy controls were enrolled in this study. Conventional and two-dimensional speckle tracking (2DSTE) echocardiography were performed. Global longitudinal strain (LS) (−23.1 ± 3.6 and −23.8 ± 4.7), and longitudinal strain rate (LSR) (−1.49 ± 0.32 and −1.76 ± 0.39) values were lower, whereas circumferential strain (CS) (−25.9 ± 4.7 and −22.8 ± 6.4) and circumferential strain rate (CSR) (−1.82 ± 0.46 and −1.69 ± 0.49) values were greater in the patient group than in the control subjects. The difference was significant for global LSR and CS (p < 0.05) values. Regional analysis showed lower LS values in the basal part of the left-ventricular (LV) free wall and lower LSR values in the basal parts of both of the septum and free wall in the patient group (p < 0.05). CS values in the anteroseptal, posterior, and inferior walls were significantly greater in the patients (p < 0.05). 2DSTE detects subtle alterations in myocardial function in asymptomatic children with CAS. Impairment of LV long-axis function occurred earlier and was more prominent in basal parts of the interventricular septum and the free wall of the left ventricle.
Literatur
1.
Zurück zum Zitat Adamu U, Schmitz F, Becker M, Kelm M, Hoffman R (2009) Advanced speckle tracking echocardiography allowing a three-myocardial layer spesific analysis of deformation parameters. Eur J Echocardiogr 10:303–308PubMedCrossRef Adamu U, Schmitz F, Becker M, Kelm M, Hoffman R (2009) Advanced speckle tracking echocardiography allowing a three-myocardial layer spesific analysis of deformation parameters. Eur J Echocardiogr 10:303–308PubMedCrossRef
2.
Zurück zum Zitat Bonow RO, Carabello BA, Kanu C, Leon AC, Faxon DP, Freed MD et al (2006) ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association task force on practise guidelines. J Am Coll Cardiol 48:1–148CrossRef Bonow RO, Carabello BA, Kanu C, Leon AC, Faxon DP, Freed MD et al (2006) ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association task force on practise guidelines. J Am Coll Cardiol 48:1–148CrossRef
3.
Zurück zum Zitat Carasso S, Cohen O, Mutlak D, Adler Z, Lessick J, Aronson D et al (2011) Relation of myocardial mechanics in severe aortic stenosis to left ventricular ejection fraction and response to aortic valve replacement. Am J Cardiol 107(7):1052–1057PubMedCrossRef Carasso S, Cohen O, Mutlak D, Adler Z, Lessick J, Aronson D et al (2011) Relation of myocardial mechanics in severe aortic stenosis to left ventricular ejection fraction and response to aortic valve replacement. Am J Cardiol 107(7):1052–1057PubMedCrossRef
4.
Zurück zum Zitat Delgado V, Tops LF, Bommel RJD, Kley FW, Marsan NA, Klautz RJ et al (2009) Strain analysis in patients with severe aortic stenosis and preserved left ventricular ejection fraction undergoing surgical valve replacement. Eur Heart J 30:3037–3047PubMedCrossRef Delgado V, Tops LF, Bommel RJD, Kley FW, Marsan NA, Klautz RJ et al (2009) Strain analysis in patients with severe aortic stenosis and preserved left ventricular ejection fraction undergoing surgical valve replacement. Eur Heart J 30:3037–3047PubMedCrossRef
5.
Zurück zum Zitat Derumeaux G, Mulder P, Richard V, Chagraoui A, Nafeh C, Bauer F et al (2002) Tissue Doppler imaging differentiates physiological from pathological pressure-overload left ventricular hypertrophy in rats. Circulation 105:1602–1608PubMedCrossRef Derumeaux G, Mulder P, Richard V, Chagraoui A, Nafeh C, Bauer F et al (2002) Tissue Doppler imaging differentiates physiological from pathological pressure-overload left ventricular hypertrophy in rats. Circulation 105:1602–1608PubMedCrossRef
6.
Zurück zum Zitat Donner R, Carabello BA, Black I (1983) Left ventricular wall stress in compensated aortic stenosis in children. Am J Cardiol 51:946–951PubMedCrossRef Donner R, Carabello BA, Black I (1983) Left ventricular wall stress in compensated aortic stenosis in children. Am J Cardiol 51:946–951PubMedCrossRef
7.
Zurück zum Zitat Guyton AC, Hall JE (2006) Heart muscle: The heart as a pump and function of the heart valves. In: Guyton AC, Hall JE (eds) Textbook of medical physiology, 11th edn. Elsevier, Philadelphia, pp 103–115 Guyton AC, Hall JE (2006) Heart muscle: The heart as a pump and function of the heart valves. In: Guyton AC, Hall JE (eds) Textbook of medical physiology, 11th edn. Elsevier, Philadelphia, pp 103–115
8.
Zurück zum Zitat Kiraly P, Kapusta L, Thijsen JM, Daniels O (2003) Left ventricular myocardial function in congenital valvar aortic stenosis assessed by ultrasound tissue-velocity and strain-rate techniques. Ultrasound Med Biol 29(4):615–620PubMedCrossRef Kiraly P, Kapusta L, Thijsen JM, Daniels O (2003) Left ventricular myocardial function in congenital valvar aortic stenosis assessed by ultrasound tissue-velocity and strain-rate techniques. Ultrasound Med Biol 29(4):615–620PubMedCrossRef
9.
Zurück zum Zitat Lam YY, Kaya MG, Li W, Gatzoulis MA, Henein MY (2007) Effect of afterload increase on left ventricular myocardial function in patients with congenital left sided obstructive lesions. J Cardiol 99:1582–1587CrossRef Lam YY, Kaya MG, Li W, Gatzoulis MA, Henein MY (2007) Effect of afterload increase on left ventricular myocardial function in patients with congenital left sided obstructive lesions. J Cardiol 99:1582–1587CrossRef
10.
Zurück zum Zitat Marcus KA, de Korte CL, Feuth T, Thijssen JM, Kapusta L (2011) Abnormal two-dimensional strain echocardiography findings in children with congenital valvar aortic stenosis. Ultraschall Med 3(7):E283–E292CrossRef Marcus KA, de Korte CL, Feuth T, Thijssen JM, Kapusta L (2011) Abnormal two-dimensional strain echocardiography findings in children with congenital valvar aortic stenosis. Ultraschall Med 3(7):E283–E292CrossRef
11.
Zurück zum Zitat Mori K, Hyabuchi Y, Inoue M, Suzuki M, Sakata M et al (2007) Myocardial strain imaging for early detection of cardiac involvement in patients with Duchenne’s muscular dystrophy. Echocardiography 24:598–608PubMedCrossRef Mori K, Hyabuchi Y, Inoue M, Suzuki M, Sakata M et al (2007) Myocardial strain imaging for early detection of cardiac involvement in patients with Duchenne’s muscular dystrophy. Echocardiography 24:598–608PubMedCrossRef
12.
Zurück zum Zitat Nesbitt GC, Mankad S, Oh JK (2009) Strain imaging in echocardiography: Methods and clinical applications. Int J Cardiovasc Imaging 25:9–22PubMedCrossRef Nesbitt GC, Mankad S, Oh JK (2009) Strain imaging in echocardiography: Methods and clinical applications. Int J Cardiovasc Imaging 25:9–22PubMedCrossRef
13.
Zurück zum Zitat Ng AC, Delgado V, Bertini M, Antoni ML, Bommel RJV, Rijinsoever EPM et al (2011) Alterations in multidirectional myocardial functions in patients with aortic stenosis and preserved ejection fraction: A two-dimensional speckle tracking analysis. Eur Heart J 32(12):1542–1550PubMedCrossRef Ng AC, Delgado V, Bertini M, Antoni ML, Bommel RJV, Rijinsoever EPM et al (2011) Alterations in multidirectional myocardial functions in patients with aortic stenosis and preserved ejection fraction: A two-dimensional speckle tracking analysis. Eur Heart J 32(12):1542–1550PubMedCrossRef
14.
Zurück zum Zitat Pacileo G, Calabrò P, Limongelli G, Russo MG, Pisacane C, Sarubbi B et al (2003) Left ventricular remodeling, mechanics, and tissue characterization in congenital aortic stenosis. J Am Soc Echocardiogr 16(3):214–220PubMedCrossRef Pacileo G, Calabrò P, Limongelli G, Russo MG, Pisacane C, Sarubbi B et al (2003) Left ventricular remodeling, mechanics, and tissue characterization in congenital aortic stenosis. J Am Soc Echocardiogr 16(3):214–220PubMedCrossRef
15.
Zurück zum Zitat Rosenhek R, Klaar U, Schemper M, Scholten C, Heger M, Gabriel H et al (2004) Mild and moderate aortic stenosis. Natural history and risk stratification by echocardiography. Eur Heart J 25:199–205PubMedCrossRef Rosenhek R, Klaar U, Schemper M, Scholten C, Heger M, Gabriel H et al (2004) Mild and moderate aortic stenosis. Natural history and risk stratification by echocardiography. Eur Heart J 25:199–205PubMedCrossRef
16.
Zurück zum Zitat Saghir M, Areces M, Makan M (2007) Strain rate imaging differentiates hypertensive cardiac hypertrophy from physiologic cardac hypertrophy (athlete’s heart). J Am Soc Echocardiogr 20:151–157PubMedCrossRef Saghir M, Areces M, Makan M (2007) Strain rate imaging differentiates hypertensive cardiac hypertrophy from physiologic cardac hypertrophy (athlete’s heart). J Am Soc Echocardiogr 20:151–157PubMedCrossRef
17.
Zurück zum Zitat Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H et al (1989) Recommendations for quantification of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr 2:358–367PubMed Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H et al (1989) Recommendations for quantification of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr 2:358–367PubMed
18.
Zurück zum Zitat Traintafyllou KA, Karabinos E, Kalkandi H, Kranidis AI, Babalis D (2009) Clinical implications of the echocardiographic assessment of the left ventricular long axis function. Clin Res Cardiol 98:521–532CrossRef Traintafyllou KA, Karabinos E, Kalkandi H, Kranidis AI, Babalis D (2009) Clinical implications of the echocardiographic assessment of the left ventricular long axis function. Clin Res Cardiol 98:521–532CrossRef
19.
Zurück zum Zitat Tsifansky M, Muñoz R, Morell VO (2010) Left ventricular outflow tract obstruction. In: Munoz R, Morell VO, Cruz EM, Vetterly CG (eds) Critical care of children with heart disease: Basic medical and surgical concepts. Springer, London, pp 241–256 Tsifansky M, Muñoz R, Morell VO (2010) Left ventricular outflow tract obstruction. In: Munoz R, Morell VO, Cruz EM, Vetterly CG (eds) Critical care of children with heart disease: Basic medical and surgical concepts. Springer, London, pp 241–256
Metadaten
Titel
Strain and Strain Rate Echocardiography Findings in Children With Asymptomatic Congenital Aortic Stenosis
verfasst von
Vehbi Dogan
Burhan Öcal
Utku Arman Orun
Senem Ozgur
Osman Yılmaz
Mahmut Keskin
Özben Ceylan
Selmin Karademir
Filiz Şenocak
Publikationsdatum
01.06.2013
Verlag
Springer-Verlag
Erschienen in
Pediatric Cardiology / Ausgabe 5/2013
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-012-0619-7

Weitere Artikel der Ausgabe 5/2013

Pediatric Cardiology 5/2013 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.