Impact of surgical aortic valve replacement on global and regional longitudinal strain across four flow gradient patterns of severe aortic stenosis
To evaluate the impact of surgical aortic valve replacement (SAVR) on global (GLS) and regional longitudinal strain (RLS) across four flow-gradient patterns of severe aortic stenosis (AS) 3 months after surgery. A total of 103 patients with severe AS (aortic valve area 35 mL/m 2 vs. ≤35 mL/m 2 ) and...
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| Veröffentlicht in: | The International Journal of Cardiovascular Imaging 2021-07, Vol.37 (7), p.2175-2187 |
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| creator | Grund, Frederik Fasth Myhr, Katrine Aagaard Visby, Lasse Hassager, Christian Mogelvang, Rasmus |
| description | To evaluate the impact of surgical aortic valve replacement (SAVR) on global (GLS) and regional longitudinal strain (RLS) across four flow-gradient patterns of severe aortic stenosis (AS) 3 months after surgery. A total of 103 patients with severe AS (aortic valve area 35 mL/m
2
vs. ≤35 mL/m
2
) and mean transaortic gradients (>40 mmhg vs. ≤40 mmhg): normal-flow, high gradient (NF/HG); low-flow, high gradient (LF/HG); normal-flow, low gradient (NF/LG); low-flow, low gradient (LF/LG). Strain analysis comprised GLS and RLS at a basal (BLS), mid-ventricular (MLS) and apical level (ALS). Patients with high gradients improved GLS (NF/HG: 16.1 ± 3.5 % vs. 17.3 ± 3.4 %, p = 0.03 and LF/HG: 15.4 ± 3.6 % vs. 16.9 ± 3.1 %, p = 0.03), BLS (NF/HG: 12.7 ± 3.1 % vs. 14.2 ± 3.1 %, p = 0.003 and LF/HG: 11.4 ± 3.2 % vs. 13.8 ± 2.7 %, p = 0.005) and MLS (NF/HG: 15.4 ± 3.3 % vs. 16.5 ± 3.3 %, p = 0.04 and LF/HG: 14.5 ± 3.1 % vs. 16.2 ± 2.7 %, p = 0.01) whereas patients with low gradients showed no improvements three months after SAVR. ALS did not change significantly in any group. Patients with high gradients demonstrated a reduction in left ventricular (LV) mass index (p |
| doi_str_mv | 10.1007/s10554-021-02187-2 |
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2
) were examined by speckle tracking echocardiography the day before SAVR and at 3-months follow-up. Patients were stratified into four flow-gradient patterns by stroke volume index (>35 mL/m
2
vs. ≤35 mL/m
2
) and mean transaortic gradients (>40 mmhg vs. ≤40 mmhg): normal-flow, high gradient (NF/HG); low-flow, high gradient (LF/HG); normal-flow, low gradient (NF/LG); low-flow, low gradient (LF/LG). Strain analysis comprised GLS and RLS at a basal (BLS), mid-ventricular (MLS) and apical level (ALS). Patients with high gradients improved GLS (NF/HG: 16.1 ± 3.5 % vs. 17.3 ± 3.4 %, p = 0.03 and LF/HG: 15.4 ± 3.6 % vs. 16.9 ± 3.1 %, p = 0.03), BLS (NF/HG: 12.7 ± 3.1 % vs. 14.2 ± 3.1 %, p = 0.003 and LF/HG: 11.4 ± 3.2 % vs. 13.8 ± 2.7 %, p = 0.005) and MLS (NF/HG: 15.4 ± 3.3 % vs. 16.5 ± 3.3 %, p = 0.04 and LF/HG: 14.5 ± 3.1 % vs. 16.2 ± 2.7 %, p = 0.01) whereas patients with low gradients showed no improvements three months after SAVR. ALS did not change significantly in any group. Patients with high gradients demonstrated a reduction in left ventricular (LV) mass index (p < 0.001) and N-terminal pro-Brain Natriuretic Peptide levels (p < 0.001) following SAVR in contrast to patients with low gradients. Patients with high gradient severe AS improve GLS and RLS three months after SAVR with concomitant reduction of LV mass and neurohormonal activation whereas patients with low gradients do not improve longitudinal strain, LV mass or neurohormonal activation.</description><identifier>ISSN: 1569-5794</identifier><identifier>EISSN: 1573-0743</identifier><identifier>EISSN: 1875-8312</identifier><identifier>DOI: 10.1007/s10554-021-02187-2</identifier><identifier>PMID: 33604765</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Aorta ; Aortic stenosis ; Aortic valve ; Brain natriuretic peptide ; Cardiac Imaging ; Cardiology ; Cardiovascular disease ; Coronary vessels ; Echocardiography ; Heart ; Heart valves ; Imaging ; Medicine ; Medicine & Public Health ; Original Paper ; Patients ; Radiology ; Stenosis ; Strain analysis ; Stroke volume ; Surgery ; Velocity ; Ventricle</subject><ispartof>The International Journal of Cardiovascular Imaging, 2021-07, Vol.37 (7), p.2175-2187</ispartof><rights>The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-c03d77c53e61ff3c1cb98ec08ef7fe89aea169a5790e26cd623b86b1a9f9c99a3</citedby><cites>FETCH-LOGICAL-c375t-c03d77c53e61ff3c1cb98ec08ef7fe89aea169a5790e26cd623b86b1a9f9c99a3</cites><orcidid>0000-0001-7835-8158</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10554-021-02187-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10554-021-02187-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33604765$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grund, Frederik Fasth</creatorcontrib><creatorcontrib>Myhr, Katrine Aagaard</creatorcontrib><creatorcontrib>Visby, Lasse</creatorcontrib><creatorcontrib>Hassager, Christian</creatorcontrib><creatorcontrib>Mogelvang, Rasmus</creatorcontrib><title>Impact of surgical aortic valve replacement on global and regional longitudinal strain across four flow gradient patterns of severe aortic stenosis</title><title>The International Journal of Cardiovascular Imaging</title><addtitle>Int J Cardiovasc Imaging</addtitle><addtitle>Int J Cardiovasc Imaging</addtitle><description>To evaluate the impact of surgical aortic valve replacement (SAVR) on global (GLS) and regional longitudinal strain (RLS) across four flow-gradient patterns of severe aortic stenosis (AS) 3 months after surgery. A total of 103 patients with severe AS (aortic valve area < 1.0 cm
2
) were examined by speckle tracking echocardiography the day before SAVR and at 3-months follow-up. Patients were stratified into four flow-gradient patterns by stroke volume index (>35 mL/m
2
vs. ≤35 mL/m
2
) and mean transaortic gradients (>40 mmhg vs. ≤40 mmhg): normal-flow, high gradient (NF/HG); low-flow, high gradient (LF/HG); normal-flow, low gradient (NF/LG); low-flow, low gradient (LF/LG). Strain analysis comprised GLS and RLS at a basal (BLS), mid-ventricular (MLS) and apical level (ALS). Patients with high gradients improved GLS (NF/HG: 16.1 ± 3.5 % vs. 17.3 ± 3.4 %, p = 0.03 and LF/HG: 15.4 ± 3.6 % vs. 16.9 ± 3.1 %, p = 0.03), BLS (NF/HG: 12.7 ± 3.1 % vs. 14.2 ± 3.1 %, p = 0.003 and LF/HG: 11.4 ± 3.2 % vs. 13.8 ± 2.7 %, p = 0.005) and MLS (NF/HG: 15.4 ± 3.3 % vs. 16.5 ± 3.3 %, p = 0.04 and LF/HG: 14.5 ± 3.1 % vs. 16.2 ± 2.7 %, p = 0.01) whereas patients with low gradients showed no improvements three months after SAVR. ALS did not change significantly in any group. Patients with high gradients demonstrated a reduction in left ventricular (LV) mass index (p < 0.001) and N-terminal pro-Brain Natriuretic Peptide levels (p < 0.001) following SAVR in contrast to patients with low gradients. Patients with high gradient severe AS improve GLS and RLS three months after SAVR with concomitant reduction of LV mass and neurohormonal activation whereas patients with low gradients do not improve longitudinal strain, LV mass or neurohormonal activation.</description><subject>Aorta</subject><subject>Aortic stenosis</subject><subject>Aortic valve</subject><subject>Brain natriuretic peptide</subject><subject>Cardiac Imaging</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Coronary vessels</subject><subject>Echocardiography</subject><subject>Heart</subject><subject>Heart valves</subject><subject>Imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Paper</subject><subject>Patients</subject><subject>Radiology</subject><subject>Stenosis</subject><subject>Strain analysis</subject><subject>Stroke volume</subject><subject>Surgery</subject><subject>Velocity</subject><subject>Ventricle</subject><issn>1569-5794</issn><issn>1573-0743</issn><issn>1875-8312</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc1u1TAQhS1ERUvhBVggS2zYhPonjuMlqvipVIlNu44cZxy5cuxgOxfxHLwwzr0tSCxYWOPRfHNGRwehN5R8oITIq0yJEG1DGN1fLxv2DF1QIXlDZMuf7_9ONUKq9hy9zPmBEMII4y_QOecdaWUnLtCvm2XVpuBocd7S7Iz2WMdUnMEH7Q-AE6xeG1ggVCjg2cdxR8JUJ7OLoTY-htmVbXJ7k0vSLmBtUswZ27glbH38geekJ7eLrLoUSCEfT8IBEjwdzAVCzC6_QmdW-wyvH-sluv_86e76a3P77cvN9cfbxnApSmMIn6Q0gkNHreWGmlH1YEgPVlrolQZNO6WrfwKsM1PH-Nh3I9XKKqOU5pfo_Ul3TfH7BrkMi8sGvNcB4pYH1iqqWiX6rqLv_kEfqrPqt1JCMCkUY22l2Ik6mk9ghzW5RaefAyXDHtlwimyocQ3HyAZWl94-Sm_jAtOflaeMKsBPQK6jMEP6e_s_sr8B-iulEQ</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Grund, Frederik Fasth</creator><creator>Myhr, Katrine Aagaard</creator><creator>Visby, Lasse</creator><creator>Hassager, Christian</creator><creator>Mogelvang, Rasmus</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7835-8158</orcidid></search><sort><creationdate>20210701</creationdate><title>Impact of surgical aortic valve replacement on global and regional longitudinal strain across four flow gradient patterns of severe aortic stenosis</title><author>Grund, Frederik Fasth ; Myhr, Katrine Aagaard ; Visby, Lasse ; Hassager, Christian ; Mogelvang, Rasmus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-c03d77c53e61ff3c1cb98ec08ef7fe89aea169a5790e26cd623b86b1a9f9c99a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aorta</topic><topic>Aortic stenosis</topic><topic>Aortic valve</topic><topic>Brain natriuretic peptide</topic><topic>Cardiac Imaging</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Coronary vessels</topic><topic>Echocardiography</topic><topic>Heart</topic><topic>Heart valves</topic><topic>Imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Paper</topic><topic>Patients</topic><topic>Radiology</topic><topic>Stenosis</topic><topic>Strain analysis</topic><topic>Stroke volume</topic><topic>Surgery</topic><topic>Velocity</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grund, Frederik Fasth</creatorcontrib><creatorcontrib>Myhr, Katrine Aagaard</creatorcontrib><creatorcontrib>Visby, Lasse</creatorcontrib><creatorcontrib>Hassager, Christian</creatorcontrib><creatorcontrib>Mogelvang, Rasmus</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>The International Journal of Cardiovascular Imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grund, Frederik Fasth</au><au>Myhr, Katrine Aagaard</au><au>Visby, Lasse</au><au>Hassager, Christian</au><au>Mogelvang, Rasmus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of surgical aortic valve replacement on global and regional longitudinal strain across four flow gradient patterns of severe aortic stenosis</atitle><jtitle>The International Journal of Cardiovascular Imaging</jtitle><stitle>Int J Cardiovasc Imaging</stitle><addtitle>Int J Cardiovasc Imaging</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>37</volume><issue>7</issue><spage>2175</spage><epage>2187</epage><pages>2175-2187</pages><issn>1569-5794</issn><eissn>1573-0743</eissn><eissn>1875-8312</eissn><abstract>To evaluate the impact of surgical aortic valve replacement (SAVR) on global (GLS) and regional longitudinal strain (RLS) across four flow-gradient patterns of severe aortic stenosis (AS) 3 months after surgery. A total of 103 patients with severe AS (aortic valve area < 1.0 cm
2
) were examined by speckle tracking echocardiography the day before SAVR and at 3-months follow-up. Patients were stratified into four flow-gradient patterns by stroke volume index (>35 mL/m
2
vs. ≤35 mL/m
2
) and mean transaortic gradients (>40 mmhg vs. ≤40 mmhg): normal-flow, high gradient (NF/HG); low-flow, high gradient (LF/HG); normal-flow, low gradient (NF/LG); low-flow, low gradient (LF/LG). Strain analysis comprised GLS and RLS at a basal (BLS), mid-ventricular (MLS) and apical level (ALS). Patients with high gradients improved GLS (NF/HG: 16.1 ± 3.5 % vs. 17.3 ± 3.4 %, p = 0.03 and LF/HG: 15.4 ± 3.6 % vs. 16.9 ± 3.1 %, p = 0.03), BLS (NF/HG: 12.7 ± 3.1 % vs. 14.2 ± 3.1 %, p = 0.003 and LF/HG: 11.4 ± 3.2 % vs. 13.8 ± 2.7 %, p = 0.005) and MLS (NF/HG: 15.4 ± 3.3 % vs. 16.5 ± 3.3 %, p = 0.04 and LF/HG: 14.5 ± 3.1 % vs. 16.2 ± 2.7 %, p = 0.01) whereas patients with low gradients showed no improvements three months after SAVR. ALS did not change significantly in any group. Patients with high gradients demonstrated a reduction in left ventricular (LV) mass index (p < 0.001) and N-terminal pro-Brain Natriuretic Peptide levels (p < 0.001) following SAVR in contrast to patients with low gradients. Patients with high gradient severe AS improve GLS and RLS three months after SAVR with concomitant reduction of LV mass and neurohormonal activation whereas patients with low gradients do not improve longitudinal strain, LV mass or neurohormonal activation.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>33604765</pmid><doi>10.1007/s10554-021-02187-2</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-7835-8158</orcidid></addata></record> |
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| subjects | Aorta Aortic stenosis Aortic valve Brain natriuretic peptide Cardiac Imaging Cardiology Cardiovascular disease Coronary vessels Echocardiography Heart Heart valves Imaging Medicine Medicine & Public Health Original Paper Patients Radiology Stenosis Strain analysis Stroke volume Surgery Velocity Ventricle |
| title | Impact of surgical aortic valve replacement on global and regional longitudinal strain across four flow gradient patterns of severe aortic stenosis |
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