Loading…
Impact of impaired myocardial deformations on exercise tolerance and prognosis in patients with asymptomatic aortic stenosis
Aims As assessed by tissue Doppler velocities, longitudinal contraction is commonly altered at an earlier stage than radial contraction in patients with severe aortic stenosis (AS). However, its relationship to exercise tolerance or to prognosis has not been clearly established. By using two-dimensi...
Saved in:
| Published in: | European journal of echocardiography 2009-05, Vol.10 (3), p.414-419 |
|---|---|
| Main Authors: | , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c379t-a1abb30c9f4fceba261a5bcfd7dfaad8a19e778d3f3e1e3cdcf8acdbfe7faba93 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c379t-a1abb30c9f4fceba261a5bcfd7dfaad8a19e778d3f3e1e3cdcf8acdbfe7faba93 |
| container_end_page | 419 |
| container_issue | 3 |
| container_start_page | 414 |
| container_title | European journal of echocardiography |
| container_volume | 10 |
| creator | Lafitte, Stéphane Perlant, Matthieu Reant, Patricia Serri, Karim Douard, Herve DeMaria, Anthony Roudaut, Raymond |
| description | Aims
As assessed by tissue Doppler velocities, longitudinal contraction is commonly altered at an earlier stage than radial contraction in patients with severe aortic stenosis (AS). However, its relationship to exercise tolerance or to prognosis has not been clearly established. By using two-dimensional (2D) echocardiographic strain, we sought to evaluate values of deformation components in the setting of severe AS and to correlate these values with exercise tolerance and with patients' outcome.
Methods and results
Sixty-five asymptomatic patients with severe AS (aortic valve area |
| doi_str_mv | 10.1093/ejechocard/jen299 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67095816</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ejechocard/jen299</oup_id><sourcerecordid>67095816</sourcerecordid><originalsourceid>FETCH-LOGICAL-c379t-a1abb30c9f4fceba261a5bcfd7dfaad8a19e778d3f3e1e3cdcf8acdbfe7faba93</originalsourceid><addsrcrecordid>eNqNkE1LAzEQhoMotlZ_gBfJyZNrN7vdjxxF_CgUvOh5mU0mNmU3WZMULfjjTT-gV0_zwjzzMjyEXLP0nqU8n-IKxdIKcHK6QpNxfkLGrMizJGNsdrrNWRFzWY3IhferNGVxOzsnI1ZzXvKiHpPfeT-ACNQqqmPSDiXtN7tODR2VqKzrIWhrPLWG4g86oT3SYDt0YARSMJIOzn4a67Wn2tAh4miCp986LCn4TT8Eu-0QFKzbDh9wR1-SMwWdx6vDnJCP56f3x9dk8fYyf3xYJCKveEiAQdvmqeBqpgS2kJUMilYoWUkFIGtgHKuqlrnKkWEupFA1CNkqrBS0wPMJud33xj-_1uhD02svsOvAoF37pqzSKIOVEWR7UDjrvUPVDE734DYNS5ut8uaovNkrjzc3h_J126M8XhwcR-BuD9j18I--P1Orlt0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>67095816</pqid></control><display><type>article</type><title>Impact of impaired myocardial deformations on exercise tolerance and prognosis in patients with asymptomatic aortic stenosis</title><source>Oxford Journals Online</source><creator>Lafitte, Stéphane ; Perlant, Matthieu ; Reant, Patricia ; Serri, Karim ; Douard, Herve ; DeMaria, Anthony ; Roudaut, Raymond</creator><creatorcontrib>Lafitte, Stéphane ; Perlant, Matthieu ; Reant, Patricia ; Serri, Karim ; Douard, Herve ; DeMaria, Anthony ; Roudaut, Raymond</creatorcontrib><description>Aims
As assessed by tissue Doppler velocities, longitudinal contraction is commonly altered at an earlier stage than radial contraction in patients with severe aortic stenosis (AS). However, its relationship to exercise tolerance or to prognosis has not been clearly established. By using two-dimensional (2D) echocardiographic strain, we sought to evaluate values of deformation components in the setting of severe AS and to correlate these values with exercise tolerance and with patients' outcome.
Methods and results
Sixty-five asymptomatic patients with severe AS (aortic valve area <1 cm2) were studied by echocardiography and exercise treadmill and were compared with controls. Conventional echographic parameters as well as longitudinal, radial, and circumferential deformations by 2D strain were measured at rest. During exercise treadmill, maximum tolerated workload, maximum heart rate, blood pressure, and EKG ST variations were recorded. Patients were then followed during 12 months. Compared with controls, despite similar ejection fractions, AS patients presented with a significantly lower global longitudinal strain (GLS) (−17.8 ± 3.5 vs. −21.1 ± 1.8%, P < 0.05) more pronounced in the basal segments (BLS) (−12.4 ± 2.9 vs. −18.4 ± 2.5%, P < 0.05). No difference was observed in terms of radial or circumferential strains. In a subgroup of AS patients with abnormal response to exercise, GLS and BLS were significantly lower (−14.7 ± 5.1 vs. −19.3 ± 4.0% and −10.7 ± 2.5 vs. −14.4 ± 2.1%, P < 0.05). With cut-offs of −18 and −13%, GLS and BLS were able to determine an inadequate exercise response with a sensitivity and specificity of 68 and 75% (AUC 0.77), and 77 and 83% (AUC 0.81), respectively. Finally, patients with a basal strain below −13% presented with more cardiac events in the follow-up.
Conclusion
In asymptomatic patients with severe AS, impaired longitudinal contraction assessed by 2D strain is associated with abnormal exercise response and with an increased risk of cardiac events during follow-up.</description><identifier>ISSN: 1525-2167</identifier><identifier>EISSN: 1532-2114</identifier><identifier>DOI: 10.1093/ejechocard/jen299</identifier><identifier>PMID: 18996958</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Aged ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - physiopathology ; Double-Blind Method ; Echocardiography, Doppler - methods ; Echocardiography, Doppler - statistics & numerical data ; Electrocardiography ; Exercise Test - methods ; Exercise Tolerance - physiology ; Female ; Follow-Up Studies ; Humans ; Male ; Myocardial Contraction - physiology ; Observer Variation ; Prognosis ; Prospective Studies ; Risk Factors ; Sensitivity and Specificity ; Treatment Outcome</subject><ispartof>European journal of echocardiography, 2009-05, Vol.10 (3), p.414-419</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org. 2009</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c379t-a1abb30c9f4fceba261a5bcfd7dfaad8a19e778d3f3e1e3cdcf8acdbfe7faba93</citedby><cites>FETCH-LOGICAL-c379t-a1abb30c9f4fceba261a5bcfd7dfaad8a19e778d3f3e1e3cdcf8acdbfe7faba93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18996958$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lafitte, Stéphane</creatorcontrib><creatorcontrib>Perlant, Matthieu</creatorcontrib><creatorcontrib>Reant, Patricia</creatorcontrib><creatorcontrib>Serri, Karim</creatorcontrib><creatorcontrib>Douard, Herve</creatorcontrib><creatorcontrib>DeMaria, Anthony</creatorcontrib><creatorcontrib>Roudaut, Raymond</creatorcontrib><title>Impact of impaired myocardial deformations on exercise tolerance and prognosis in patients with asymptomatic aortic stenosis</title><title>European journal of echocardiography</title><addtitle>Eur J Echocardiogr</addtitle><description>Aims
As assessed by tissue Doppler velocities, longitudinal contraction is commonly altered at an earlier stage than radial contraction in patients with severe aortic stenosis (AS). However, its relationship to exercise tolerance or to prognosis has not been clearly established. By using two-dimensional (2D) echocardiographic strain, we sought to evaluate values of deformation components in the setting of severe AS and to correlate these values with exercise tolerance and with patients' outcome.
Methods and results
Sixty-five asymptomatic patients with severe AS (aortic valve area <1 cm2) were studied by echocardiography and exercise treadmill and were compared with controls. Conventional echographic parameters as well as longitudinal, radial, and circumferential deformations by 2D strain were measured at rest. During exercise treadmill, maximum tolerated workload, maximum heart rate, blood pressure, and EKG ST variations were recorded. Patients were then followed during 12 months. Compared with controls, despite similar ejection fractions, AS patients presented with a significantly lower global longitudinal strain (GLS) (−17.8 ± 3.5 vs. −21.1 ± 1.8%, P < 0.05) more pronounced in the basal segments (BLS) (−12.4 ± 2.9 vs. −18.4 ± 2.5%, P < 0.05). No difference was observed in terms of radial or circumferential strains. In a subgroup of AS patients with abnormal response to exercise, GLS and BLS were significantly lower (−14.7 ± 5.1 vs. −19.3 ± 4.0% and −10.7 ± 2.5 vs. −14.4 ± 2.1%, P < 0.05). With cut-offs of −18 and −13%, GLS and BLS were able to determine an inadequate exercise response with a sensitivity and specificity of 68 and 75% (AUC 0.77), and 77 and 83% (AUC 0.81), respectively. Finally, patients with a basal strain below −13% presented with more cardiac events in the follow-up.
Conclusion
In asymptomatic patients with severe AS, impaired longitudinal contraction assessed by 2D strain is associated with abnormal exercise response and with an increased risk of cardiac events during follow-up.</description><subject>Aged</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - physiopathology</subject><subject>Double-Blind Method</subject><subject>Echocardiography, Doppler - methods</subject><subject>Echocardiography, Doppler - statistics & numerical data</subject><subject>Electrocardiography</subject><subject>Exercise Test - methods</subject><subject>Exercise Tolerance - physiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Myocardial Contraction - physiology</subject><subject>Observer Variation</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Treatment Outcome</subject><issn>1525-2167</issn><issn>1532-2114</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNqNkE1LAzEQhoMotlZ_gBfJyZNrN7vdjxxF_CgUvOh5mU0mNmU3WZMULfjjTT-gV0_zwjzzMjyEXLP0nqU8n-IKxdIKcHK6QpNxfkLGrMizJGNsdrrNWRFzWY3IhferNGVxOzsnI1ZzXvKiHpPfeT-ACNQqqmPSDiXtN7tODR2VqKzrIWhrPLWG4g86oT3SYDt0YARSMJIOzn4a67Wn2tAh4miCp986LCn4TT8Eu-0QFKzbDh9wR1-SMwWdx6vDnJCP56f3x9dk8fYyf3xYJCKveEiAQdvmqeBqpgS2kJUMilYoWUkFIGtgHKuqlrnKkWEupFA1CNkqrBS0wPMJud33xj-_1uhD02svsOvAoF37pqzSKIOVEWR7UDjrvUPVDE734DYNS5ut8uaovNkrjzc3h_J126M8XhwcR-BuD9j18I--P1Orlt0</recordid><startdate>20090501</startdate><enddate>20090501</enddate><creator>Lafitte, Stéphane</creator><creator>Perlant, Matthieu</creator><creator>Reant, Patricia</creator><creator>Serri, Karim</creator><creator>Douard, Herve</creator><creator>DeMaria, Anthony</creator><creator>Roudaut, Raymond</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090501</creationdate><title>Impact of impaired myocardial deformations on exercise tolerance and prognosis in patients with asymptomatic aortic stenosis</title><author>Lafitte, Stéphane ; Perlant, Matthieu ; Reant, Patricia ; Serri, Karim ; Douard, Herve ; DeMaria, Anthony ; Roudaut, Raymond</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c379t-a1abb30c9f4fceba261a5bcfd7dfaad8a19e778d3f3e1e3cdcf8acdbfe7faba93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - physiopathology</topic><topic>Double-Blind Method</topic><topic>Echocardiography, Doppler - methods</topic><topic>Echocardiography, Doppler - statistics & numerical data</topic><topic>Electrocardiography</topic><topic>Exercise Test - methods</topic><topic>Exercise Tolerance - physiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Myocardial Contraction - physiology</topic><topic>Observer Variation</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Treatment Outcome</topic><toplevel>online_resources</toplevel><creatorcontrib>Lafitte, Stéphane</creatorcontrib><creatorcontrib>Perlant, Matthieu</creatorcontrib><creatorcontrib>Reant, Patricia</creatorcontrib><creatorcontrib>Serri, Karim</creatorcontrib><creatorcontrib>Douard, Herve</creatorcontrib><creatorcontrib>DeMaria, Anthony</creatorcontrib><creatorcontrib>Roudaut, Raymond</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of echocardiography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lafitte, Stéphane</au><au>Perlant, Matthieu</au><au>Reant, Patricia</au><au>Serri, Karim</au><au>Douard, Herve</au><au>DeMaria, Anthony</au><au>Roudaut, Raymond</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of impaired myocardial deformations on exercise tolerance and prognosis in patients with asymptomatic aortic stenosis</atitle><jtitle>European journal of echocardiography</jtitle><addtitle>Eur J Echocardiogr</addtitle><date>2009-05-01</date><risdate>2009</risdate><volume>10</volume><issue>3</issue><spage>414</spage><epage>419</epage><pages>414-419</pages><issn>1525-2167</issn><eissn>1532-2114</eissn><abstract>Aims
As assessed by tissue Doppler velocities, longitudinal contraction is commonly altered at an earlier stage than radial contraction in patients with severe aortic stenosis (AS). However, its relationship to exercise tolerance or to prognosis has not been clearly established. By using two-dimensional (2D) echocardiographic strain, we sought to evaluate values of deformation components in the setting of severe AS and to correlate these values with exercise tolerance and with patients' outcome.
Methods and results
Sixty-five asymptomatic patients with severe AS (aortic valve area <1 cm2) were studied by echocardiography and exercise treadmill and were compared with controls. Conventional echographic parameters as well as longitudinal, radial, and circumferential deformations by 2D strain were measured at rest. During exercise treadmill, maximum tolerated workload, maximum heart rate, blood pressure, and EKG ST variations were recorded. Patients were then followed during 12 months. Compared with controls, despite similar ejection fractions, AS patients presented with a significantly lower global longitudinal strain (GLS) (−17.8 ± 3.5 vs. −21.1 ± 1.8%, P < 0.05) more pronounced in the basal segments (BLS) (−12.4 ± 2.9 vs. −18.4 ± 2.5%, P < 0.05). No difference was observed in terms of radial or circumferential strains. In a subgroup of AS patients with abnormal response to exercise, GLS and BLS were significantly lower (−14.7 ± 5.1 vs. −19.3 ± 4.0% and −10.7 ± 2.5 vs. −14.4 ± 2.1%, P < 0.05). With cut-offs of −18 and −13%, GLS and BLS were able to determine an inadequate exercise response with a sensitivity and specificity of 68 and 75% (AUC 0.77), and 77 and 83% (AUC 0.81), respectively. Finally, patients with a basal strain below −13% presented with more cardiac events in the follow-up.
Conclusion
In asymptomatic patients with severe AS, impaired longitudinal contraction assessed by 2D strain is associated with abnormal exercise response and with an increased risk of cardiac events during follow-up.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>18996958</pmid><doi>10.1093/ejechocard/jen299</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1525-2167 |
| ispartof | European journal of echocardiography, 2009-05, Vol.10 (3), p.414-419 |
| issn | 1525-2167 1532-2114 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_67095816 |
| source | Oxford Journals Online |
| subjects | Aged Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - physiopathology Double-Blind Method Echocardiography, Doppler - methods Echocardiography, Doppler - statistics & numerical data Electrocardiography Exercise Test - methods Exercise Tolerance - physiology Female Follow-Up Studies Humans Male Myocardial Contraction - physiology Observer Variation Prognosis Prospective Studies Risk Factors Sensitivity and Specificity Treatment Outcome |
| title | Impact of impaired myocardial deformations on exercise tolerance and prognosis in patients with asymptomatic aortic stenosis |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T06%3A52%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20impaired%20myocardial%20deformations%20on%20exercise%20tolerance%20and%20prognosis%20in%20patients%20with%20asymptomatic%20aortic%20stenosis&rft.jtitle=European%20journal%20of%20echocardiography&rft.au=Lafitte,%20St%C3%A9phane&rft.date=2009-05-01&rft.volume=10&rft.issue=3&rft.spage=414&rft.epage=419&rft.pages=414-419&rft.issn=1525-2167&rft.eissn=1532-2114&rft_id=info:doi/10.1093/ejechocard/jen299&rft_dat=%3Cproquest_cross%3E67095816%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c379t-a1abb30c9f4fceba261a5bcfd7dfaad8a19e778d3f3e1e3cdcf8acdbfe7faba93%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=67095816&rft_id=info:pmid/18996958&rft_oup_id=10.1093/ejechocard/jen299&rfr_iscdi=true |