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Assessment of Longitudinal Systolic Functions of Patients with Asymptomatic Aortic Stenosis by Strain and Strain Rate

Year 2019, Volume: 6 Issue: 1, 1 - 4, 20.03.2019

Abstract

To investigate the longitudinal systolic
functions of the heart with a strain and strain rate in patients with preserved
horizontal systolic function (EF) with aortic stenosis. 18 consecutive patients
(mean age 55±15 years, 10 men) with aortic stenosis were included in the study.
The control group consisted of 12 consecutive patients (mean age 50±6 years, 4 men)
without any valve disease. In all patients, color doppler images of the
posterior wall, lateral wall, etc. were obtained in accordance with the
guidelines. All measurements were calculated by taking the average of 3 cycles.
After collection of patient data, the aortic valve area was calculated
according to the continuity equations of currents. It was calculated from the
basal portion of the images of the "strain and strain rates" of color
doppler images. As a result, we obtained the total value by taking the average
"strain and strain rates" of the 5 walls examined. The left
ventricular ejection fractions were found to be preserved but not significantly
different between the two groups (p=0.01). In the group with aortic stenosis,
the deceleration time (DT) was found to be significantly higher than the normal
group (p=0.03). There was a significant difference between the two groups in
terms of total strain and strain rate values of the left ventricle (p =0.002).
In patients with aortic stenosis, echocardiographic total strain and strain
rate values decreased significantly.

References

  • 1. Kowalski M, Herbots L, Weidemann F, et al. One-dimensional ultrasonic strain and strain rate imaging: a new approach to the quantitation of miyocardial function in patients with aortic stenosis. Ultrasound Med Biol. 2003;29(8):1085-92.
  • 2. Takeda S, Rimington H, Smeeton N, Chambers J. Long axis excursion in aortic stenosis. Heart. 2001;86(1):52-6.
  • 3. Pellikka PA, Nishimura RA, Bailey KR, Tajik AJ. The natural history of adults with asymptomatic, hemodinamically significant aortic stenosis. J Am Coll Cardiol. 1990;15(5):1012-7.
  • 4. Lund O, Nielsen TT, Emmertsen K, et al. Mortality and worsening of prognostic profile during waiting time for valve replacement in aortic stenosis. Thorac Cardiovasc Surg. 1996;44(6):289-95.
  • 5. Turina J, Hess O, Sepulcri F, Krayenbuehl HP. Sponteneous course of aortic valve disease. Eur Heart J. 1987;8(5):471-83.
  • 6. Lindblom D, Lindblom U, Qvist J, Lundström H. Long-term relative survival rates after heart valve replacement. J Am Coll Cardiol. 1990;15(3):566-73.
  • 7. Kelly TA, Rothbart RM, Cooper CM, Kaiser DL, Smucker ML, Gibson RS. Comparison of outcome of asymptomatic to symptomatic patiens older than 20 years of age with valvular aortic stenosis. Am J Cardiol. 1988;61(1):123-30.
  • 8. Schulman DS, Remetz MS, Elefteriades J, Frances CK. Mild mitral insufficiensy is a marker of impaired left ventricular performance in aortic stenosis. J Am Coll Cardiol. 1989;13(4):796-803.
  • 9. Brener SJ, Duffy CI, Thomas JD, Stewart WJ. Progression of aortic stenosis in 394 patients relation to changes in myocardial and mitral valve disfunctions. J Am Coll Cardiol. 1995;25(2):305-10.
  • 10. Kennedy KD, Nishimura RA, Holmes DR Jr, Bailey KR. The natural history of moderate aortic stenosis. J Am Coll Cardiol. 1991;17(2):313-9.
  • 11. Frank S, Johnson A, Ross J Jr. Natural history of valvular aortic stenosis. Br Heart J.1973;35(1):41-6.
  • 12. Kowalski, M. Herbots L, Weidemann F, et al. One-dimensional ultrasonic strain and strain rate imaging: a new approach to the quantitation of regional myocardial function in patients with aortic stenosis. Ultrasound Med. Biol. 2003;29(8):1085-92.
  • 13. Carasso, S. Cohen O, Mutlak D, et al. Relation of myocardial mechanics in severe aortic stenosis to left ventricular ejection fraction and response to aortic valve replacement. Am J Cardiol. 2011 Apr 1;107(7):1052-7.
  • 14. Claus P, Bijnens B, Weideman F, et al. Post systolic thickening in ischemic myocardium: A simple mathematical model for simulating regional deformation; functional imaging and modelling of the heart. Lect Notes Comput Sci. 2001;2230:134–9.
  • 15. Di Bello V, Talarico L, Picano E, et al. Increased myocardial echo density in left ventricular pressure and volüme overload in human aortic valvular disease: An ultrasonic tissue characterization study. J Am Soc Echocardiogr. 1997;10(4):320–9.
  • 16. Fielitz J, Hein S, Mitrovic V, et al. Activation of the cardiac renin–angiotensin system and increased myocardial collagen expression in human aortic valve disease. J Am Coll Cardiol. 2001;37(5):1443–9.
  • 17. Edvardsen T, Helle-Valle T, Smiseth OA. Systolic dysfunction in heart failure with normal ejection fraction: Speckle-tracking echocardiography. Prog Cardiovasc Dis. 2006;49(3):207–14.
  • 18. Vinereanu D, Lim PO, Frenneaux MP, Fraser AG. Reduced myocardial velocities of left ventricular long-axis contraction identify both systolic and diastolic heart failure—A comparison with brain natriuretic peptide. Eur J Heart Fail. 2005;7(4):512–9.
  • 19. Henein MY, Priestley K, Davarashyi T, Buller N, Gibson DG. Early changes in left ventricular subendocardial function after successful coronary angioplasty. Br Heart J. 1993;69(6):501-6.
  • 20. Henein MY, Gibson DG. Suppression of left venricular early diastolic filling by long axis asynchrony. Br Heart J. 1995;73(2):151-7.
  • 21. Henein MY, Gibson DG. Abnormal subendocardial function in restrictive left ventricular disease. Br Heart J. 1994;72(3):237-42.
  • 22. Alam M, Hoglund C, Thorstrand C, Philip A. Atrioventricular pplane displacement in severe congestive heart failure following dilated cardiomyopathy or myocardial infarction. J Intern Med. 1990;228(6):569-75.

Asemptomatik Aort Darlığı Olan Hastaların Dikey Sistolik Fonksiyonlarının Strain ve Strain Rate ile Değerlendirilmesi

Year 2019, Volume: 6 Issue: 1, 1 - 4, 20.03.2019

Abstract

Aort darlığı olan yatay sistolik fonksiyonları
(EF) korunmuş hastalarda kalbin dikey sistolik fonksiyonlarını yeni bir
ekokardiyografik yöntem olan strain ve strain rate ile incelenmesi. Çalışmaya
aort darlığı tespit edilen 18 ardışık (ortalama yaş 55±15yıl, 10 erkek) hasta
dahil edildi. Kontrol grubu ise herhangi bir kapak hastalığı olmayan 12 ardışık
(ortalama yaş 50±6yıl, 4 erkek) hastadan oluşturuldu. Tüm bireylerde,
kılavuzlara uygun şekilde arka duvar, interventriküler septum, yan duvar, ön ve
alt duvar renkli doppler görüntüleri alındı. Bütün ölçümler 3 siklusun
ortalaması alınarak hesaplandı. Hasta verileri toplandıktan sonra akımların
süreklilik denklemlerine göre aort kapak alanı hesaplandı. Alınan renkli
doppler görüntülerinin “strain ve strain rate”lerinin görüntülerinin bazal
kısmından hesaplandı. Sonuçta bakılan 5 duvarın ortalama “strain ve strain
rate”lerini alarak toplam değer elde ettik. İstatistiksel analiz Student
t-testi ve Mann-Whitney U testi kullanılarak yapıldı. Her iki grup arasında sol
ventrikül ejeksiyon fraksiyonları anlamlı farklılık gösterse de korunmuş olarak
bulundu (p=0.01). Aort darlığı olan grupta deselerasyon zamanı (DZ) normal
gruba göre anlamlı derecede artmış olarak tespit edildi (p=0.03). Sol
ventrikülün toplam strain ve strain rate değerleri açısından 2 grup arasında
anlamlı fark bulundu (p=0,002). Sadece arka duvarlar arasında anlamlı fark
bulunamadı (Hasta:1.82±0.50, kontrol:1.55±0.66, p=0.258). Aort darlığı olan
hastalarda ekokardiyografik olarak bakılan toplam strain ve strain rate
değerleri anlamlı şekilde azalmıştır.

References

  • 1. Kowalski M, Herbots L, Weidemann F, et al. One-dimensional ultrasonic strain and strain rate imaging: a new approach to the quantitation of miyocardial function in patients with aortic stenosis. Ultrasound Med Biol. 2003;29(8):1085-92.
  • 2. Takeda S, Rimington H, Smeeton N, Chambers J. Long axis excursion in aortic stenosis. Heart. 2001;86(1):52-6.
  • 3. Pellikka PA, Nishimura RA, Bailey KR, Tajik AJ. The natural history of adults with asymptomatic, hemodinamically significant aortic stenosis. J Am Coll Cardiol. 1990;15(5):1012-7.
  • 4. Lund O, Nielsen TT, Emmertsen K, et al. Mortality and worsening of prognostic profile during waiting time for valve replacement in aortic stenosis. Thorac Cardiovasc Surg. 1996;44(6):289-95.
  • 5. Turina J, Hess O, Sepulcri F, Krayenbuehl HP. Sponteneous course of aortic valve disease. Eur Heart J. 1987;8(5):471-83.
  • 6. Lindblom D, Lindblom U, Qvist J, Lundström H. Long-term relative survival rates after heart valve replacement. J Am Coll Cardiol. 1990;15(3):566-73.
  • 7. Kelly TA, Rothbart RM, Cooper CM, Kaiser DL, Smucker ML, Gibson RS. Comparison of outcome of asymptomatic to symptomatic patiens older than 20 years of age with valvular aortic stenosis. Am J Cardiol. 1988;61(1):123-30.
  • 8. Schulman DS, Remetz MS, Elefteriades J, Frances CK. Mild mitral insufficiensy is a marker of impaired left ventricular performance in aortic stenosis. J Am Coll Cardiol. 1989;13(4):796-803.
  • 9. Brener SJ, Duffy CI, Thomas JD, Stewart WJ. Progression of aortic stenosis in 394 patients relation to changes in myocardial and mitral valve disfunctions. J Am Coll Cardiol. 1995;25(2):305-10.
  • 10. Kennedy KD, Nishimura RA, Holmes DR Jr, Bailey KR. The natural history of moderate aortic stenosis. J Am Coll Cardiol. 1991;17(2):313-9.
  • 11. Frank S, Johnson A, Ross J Jr. Natural history of valvular aortic stenosis. Br Heart J.1973;35(1):41-6.
  • 12. Kowalski, M. Herbots L, Weidemann F, et al. One-dimensional ultrasonic strain and strain rate imaging: a new approach to the quantitation of regional myocardial function in patients with aortic stenosis. Ultrasound Med. Biol. 2003;29(8):1085-92.
  • 13. Carasso, S. Cohen O, Mutlak D, et al. Relation of myocardial mechanics in severe aortic stenosis to left ventricular ejection fraction and response to aortic valve replacement. Am J Cardiol. 2011 Apr 1;107(7):1052-7.
  • 14. Claus P, Bijnens B, Weideman F, et al. Post systolic thickening in ischemic myocardium: A simple mathematical model for simulating regional deformation; functional imaging and modelling of the heart. Lect Notes Comput Sci. 2001;2230:134–9.
  • 15. Di Bello V, Talarico L, Picano E, et al. Increased myocardial echo density in left ventricular pressure and volüme overload in human aortic valvular disease: An ultrasonic tissue characterization study. J Am Soc Echocardiogr. 1997;10(4):320–9.
  • 16. Fielitz J, Hein S, Mitrovic V, et al. Activation of the cardiac renin–angiotensin system and increased myocardial collagen expression in human aortic valve disease. J Am Coll Cardiol. 2001;37(5):1443–9.
  • 17. Edvardsen T, Helle-Valle T, Smiseth OA. Systolic dysfunction in heart failure with normal ejection fraction: Speckle-tracking echocardiography. Prog Cardiovasc Dis. 2006;49(3):207–14.
  • 18. Vinereanu D, Lim PO, Frenneaux MP, Fraser AG. Reduced myocardial velocities of left ventricular long-axis contraction identify both systolic and diastolic heart failure—A comparison with brain natriuretic peptide. Eur J Heart Fail. 2005;7(4):512–9.
  • 19. Henein MY, Priestley K, Davarashyi T, Buller N, Gibson DG. Early changes in left ventricular subendocardial function after successful coronary angioplasty. Br Heart J. 1993;69(6):501-6.
  • 20. Henein MY, Gibson DG. Suppression of left venricular early diastolic filling by long axis asynchrony. Br Heart J. 1995;73(2):151-7.
  • 21. Henein MY, Gibson DG. Abnormal subendocardial function in restrictive left ventricular disease. Br Heart J. 1994;72(3):237-42.
  • 22. Alam M, Hoglund C, Thorstrand C, Philip A. Atrioventricular pplane displacement in severe congestive heart failure following dilated cardiomyopathy or myocardial infarction. J Intern Med. 1990;228(6):569-75.
There are 22 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section Original Article
Authors

Ahmet Genç 0000-0003-0797-8418

Şevket Görgülü This is me 0000-0001-6139-8305

Mehmet Eren 0000-0002-5570-705X

Publication Date March 20, 2019
Submission Date July 27, 2018
Published in Issue Year 2019 Volume: 6 Issue: 1

Cite

APA Genç, A., Görgülü, Ş., & Eren, M. (2019). Asemptomatik Aort Darlığı Olan Hastaların Dikey Sistolik Fonksiyonlarının Strain ve Strain Rate ile Değerlendirilmesi. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 6(1), 1-4.
AMA Genç A, Görgülü Ş, Eren M. Asemptomatik Aort Darlığı Olan Hastaların Dikey Sistolik Fonksiyonlarının Strain ve Strain Rate ile Değerlendirilmesi. MMJ. March 2019;6(1):1-4.
Chicago Genç, Ahmet, Şevket Görgülü, and Mehmet Eren. “Asemptomatik Aort Darlığı Olan Hastaların Dikey Sistolik Fonksiyonlarının Strain Ve Strain Rate Ile Değerlendirilmesi”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 6, no. 1 (March 2019): 1-4.
EndNote Genç A, Görgülü Ş, Eren M (March 1, 2019) Asemptomatik Aort Darlığı Olan Hastaların Dikey Sistolik Fonksiyonlarının Strain ve Strain Rate ile Değerlendirilmesi. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 6 1 1–4.
IEEE A. Genç, Ş. Görgülü, and M. Eren, “Asemptomatik Aort Darlığı Olan Hastaların Dikey Sistolik Fonksiyonlarının Strain ve Strain Rate ile Değerlendirilmesi”, MMJ, vol. 6, no. 1, pp. 1–4, 2019.
ISNAD Genç, Ahmet et al. “Asemptomatik Aort Darlığı Olan Hastaların Dikey Sistolik Fonksiyonlarının Strain Ve Strain Rate Ile Değerlendirilmesi”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 6/1 (March 2019), 1-4.
JAMA Genç A, Görgülü Ş, Eren M. Asemptomatik Aort Darlığı Olan Hastaların Dikey Sistolik Fonksiyonlarının Strain ve Strain Rate ile Değerlendirilmesi. MMJ. 2019;6:1–4.
MLA Genç, Ahmet et al. “Asemptomatik Aort Darlığı Olan Hastaların Dikey Sistolik Fonksiyonlarının Strain Ve Strain Rate Ile Değerlendirilmesi”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, vol. 6, no. 1, 2019, pp. 1-4.
Vancouver Genç A, Görgülü Ş, Eren M. Asemptomatik Aort Darlığı Olan Hastaların Dikey Sistolik Fonksiyonlarının Strain ve Strain Rate ile Değerlendirilmesi. MMJ. 2019;6(1):1-4.