The predictive value of left ventricular myocardium mechanics evaluation in asymptomatic patients with aortic regurgitation and preserved left ventricular ejection fraction. A long‐term speckle‐tracking echocardiographic study.
Background: The management of asymptomatic patients with aortic regurgitation (AR) and preserved left ventricular (LV) ejection fraction (LVEF) remains challenging. The purpose of the study was to assess the early changes of LV mechanics by 2D speckle‐tracking echocardiography (2D‐STE) in order to p...
| Publicado en: | Echocardiography Vol. 35; no. 9; pp. 1277 - 1289 |
|---|---|
| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Sep2018
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=131755070&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 131755070 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Sep2018 vid: 35 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 131755070 131755070 131755070 10.1111/echo.14030 131755070 ppf: 1277 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: The predictive value of left ventricular myocardium mechanics evaluation in asymptomatic patients with aortic regurgitation and preserved left ventricular ejection fraction. A long‐term speckle‐tracking echocardiographic study. aug: au: Verseckaite, Raimonda Mizariene, Vaida Montvilaite, Aiste Auguste, Indre Bieseviciene, Monika Laukaitiene, Jolanta Jonkaitiene, Regina Jurkevicius, Renaldas affil: Department of Cardiology, Hospital of Lithuanian University of Health Sciences, Kaunas Clinics, Kaunas, Lithuania sug: subj: Ventricular Ejection Fraction Evaluation Echocardiography Aortic Valve Insufficiency Diagnosis Cardiac Patients Evaluation Myocardium Human Heart Ventricle, Left Physiology Adult Aortic Valve Insufficiency Classification Aortic Valve Insufficiency Surgery Cardiac Surgery Prospective Studies Adult: 19-44 years ab: Background: The management of asymptomatic patients with aortic regurgitation (AR) and preserved left ventricular (LV) ejection fraction (LVEF) remains challenging. The purpose of the study was to assess the early changes of LV mechanics by 2D speckle‐tracking echocardiography (2D‐STE) in order to predict a decrease in LVEF. Methods: Sixty‐seven patients (age, 47 ± 15 years) with asymptomatic moderate (n = 27) and severe AR (n = 40) with preserved LVEF were prospectively followed for about 5 years. Sixty healthy age‐matched controls were included in the study. Standard echocardiography and 2D‐STE were performed at the baseline and follow‐up. The primary endpoint was a deterioration of the LVEF (≤50%). Results: At baseline, global LV longitudinal peak systolic strain (GLS) and strain rate (GLSRs) were decreased in patients with severe AR compared to controls (−18.9 ± 2.4 vs 20.0 ± 2.1%; −1.05 ± 0.19 vs −1.18 ± 0.15 1/s, P < .05, respectively). In the moderate AR group, GLS was not different from that of the control group, but GLSRs was significantly lower than in controls. The primary endpoint was reached in 12 patients with severe AR, while this was not observed in patients with moderate AR. In multivariate analysis, GLS was an independent predictor of LVEF. According to ROC curve analysis, probability of primary endpoint occurrence was significantly greater in patients with GLS values ≥−18.5% (AUC: 0.89, P < .01). Conclusions: The reduction of LV longitudinal deformation is a sign of early subclinical LV dysfunction. GLS is a prognostic predictor of LV dysfunction and may be potentially useful for optimal timing of surgery for patients with significant AR. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|