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The International Journal of Cardiovascular Imaging

01.04.2013 | Original Paper

Speckle tracking echocardiography derived 2-dimensional myocardial strain predicts left ventricular function and mass regression in aortic stenosis patients undergoing aortic valve replacement

verfasst von: Adam Staron, Manish Bansal, Piyush Kalakoti, Ayumi Nakabo, Zbigniew Gasior, Piotr Pysz, Krystian Wita, Marek Jasinski, Partho P. Sengupta

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 4/2013

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Abstract

Regression of left ventricular (LV) mass in severe aortic stenosis (AS) following aortic valve replacement (AVR) reduces the potential risk of sudden death and congestive heart failure associated with LV hypertrophy. We investigated whether abnormalities of resting LV deformation in severe AS can predict the lack of regression of LV mass following AVR. Two-dimensional speckle tracking echocardiography (STE) was performed in a total of 100 subjects including 60 consecutive patients with severe AS having normal LV ejection fraction (EF > 50 %) and 40 controls. STE was performed preoperatively and at 4 months following AVR, including longitudinal strain assessed from the apical 4-chamber and 2-chamber views and the circumferential and rotational mechanics measured from the apical short axis view. In comparison with controls, the patients with AS showed a significantly lower LV longitudinal (p < 0.001) and circumferential strain (p < 0.05) and higher apical rotation (p < 0.001). Following AVR, a significant improvement was seen in both strains (p < 0.001 for each respectively), however, apical rotation remained unchanged (p = 0.14). On multivariate analysis, baseline LV mass (odds ratio 1.02; p = 0.011), left atrial volume (odds ratio 0.81; p = 0.048) and circumferential strain (odds ratio 0.84; p = 0.02) independently predicted LV mass regression (>10 %) following AVR. In conclusion, STE can quantify the burden of myocardial dysfunction in patients with severe AS despite the presence of normal LV ejection fraction. Furthermore, resting abnormalities in circumferential strain at LV apex is related with a hemodynamic milieu associated with the lack of LV mass regression during short-term follow up after AVR.

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Titel: Speckle tracking echocardiography derived 2-dimensional myocardial strain predicts left ventricular function and mass regression in aortic stenosis patients undergoing aortic valve replacement
verfasst von: Adam Staron
Manish Bansal
Piyush Kalakoti
Ayumi Nakabo
Zbigniew Gasior
Piotr Pysz
Krystian Wita
Marek Jasinski
Partho P. Sengupta
Publikationsdatum: 01.04.2013
Verlag: Springer Netherlands
Erschienen in: The International Journal of Cardiovascular Imaging / Ausgabe 4/2013
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-012-0160-z

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Speckle tracking echocardiography derived 2-dimensional myocardial strain predicts left ventricular function and mass regression in aortic stenosis patients undergoing aortic valve replacement

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