Heterogeneity of systolic dysfunction in patients with severe aortic stenosis and preserved ejection fraction.
Heterogeneity of systolic dysfunction in patients with severe aortic stenosis and preserved ejection fraction.
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DOI：
10.1111/jocs.13183
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发表时间：
2017-08
影响因子：
1.6
通讯作者：
Pasque MK
中科院分区：
文献类型：
--
作者：
Lindman BR;Liu Q;Cupps BP;Woodard PK;Novak E;Vatterott AM;Koerner DJ;Kulshrestha K;Pasque MK
左心室（LV）收缩期应变已被证明是严重主动脉瓣狭窄（AS）患者（尽管射血分数（EF）保留）LV功能障碍的早期标志。超声心动图提供了关于局部LV应变模式的有用数据，但不如磁共振成像（MRI）敏感。之前没有研究使用基于MRI的应变分析来表征重度AS患者的局部3D应变。12例严重AS和保留EF的患者进行了基于MRI的多参数应变分析。在整个LV的各个点计算周向和纵向应变值，并在12个离散区域进行分析。将应变值与正常对照数据库进行比较。与对照组患者相比，AS患者的基底壁（p=0.002）、中间壁（p=0.042）和下壁（p<0.001）的周向应变显著降低。基底壁（p<0.001）、中间壁（p<0.001）、前壁（p<0.001）和间隔壁（p<0.001）的纵向应变显著降低。在AS患者中，尽管存在保留的EF和缺乏既往心肌梗死，但周向和纵向应变异常的位置和严重程度存在异质性。与健康志愿者相比，左室收缩应变在AS患者中显著受损，EF保留。环向应变和纵向应变在AS患者的LV中分布不均匀，这使我们能够确定可能反映LV功能障碍最早体征的哨兵区域。
Left ventricular (LV) systolic strain has been shown to be an early marker of LV dysfunction in patients with severe aortic stenosis (AS) despite preserved ejection fraction (EF). Echocardiography has provided useful data on regional LV strain patterns but is not as sensitive as magnetic resonance imaging (MRI). No prior studies have used MRI-based strain analysis to characterize regional 3D strain in patients with severe AS. Twelve patients with severe AS and preserved EF underwent MRI-based multiparametric strain analysis. Circumferential and longitudinal strain values were calculated at individual points throughout the LV and analyzed in 12 discrete regions. Strain values were compared to a database of normal controls. Compared to control patients, circumferential strain in AS patients was significantly reduced at the base (p=0.002), mid (p=0.042), and inferior walls (p<0.001). Longitudinal strain was significantly reduced at the base (p<0.001), mid (p<0.001), anterior (p<0.001), and septal (p<0.001) walls. Among patients with AS, there was heterogeneity in the location and severity of abnormalities in circumferential and longitudinal strain despite the presence of a preserved EF and lack of prior myocardial infarction. LV systolic strain is significantly impaired in patients with AS and preserved EF compared to healthy volunteers. Abnormalities in circumferential and longitudinal strain were heterogeneously distributed across the LV of patients with AS, allowing us to identify sentinel regions that may reflect the earliest signs of developing LV dysfunction.
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影响因子：
--
作者：
Cupps BP;Taggar AK;Reynolds LM;Lawton JS;Pasque MK
通讯作者：
Pasque MK
DOI：
10.1016/j.echo.2013.05.004
发表时间：
2013-08-01
影响因子：
6.5
作者：
Attias, David;Macron, Laurent;Messika-Zeitoun, David
通讯作者：
Messika-Zeitoun, David
DOI：
10.1016/j.echo.2013.10.002
发表时间：
2014-01-01
影响因子：
6.5
作者：
Kaku, Kyoko;Takeuchi, Masaaki;Otsuji, Yutaka
通讯作者：
Otsuji, Yutaka
影响因子：
--
作者：
Lancellotti, Patrizio;Donal, Erwan;Pierard, Luc A.
通讯作者：
Pierard, Luc A.
影响因子：
6.2
作者：
Lang, Roberto M.;Badano, Luigi P.;Voigt, Jens-Uwe
通讯作者：
Voigt, Jens-Uwe