TY - JOUR
T1 - Myocardial systolic strain is decreased after aortic valve replacement in patients with aortic insufficiency
AU - Pomerantz, Benjamin J.
AU - Wollmuth, Jason R.
AU - Krock, Marc D.
AU - Cupps, Brian P.
AU - Moustakidis, Pavlos
AU - Kouchoukos, Nicholas T.
AU - Davila-Roman, Victor G.
AU - Pasque, Michael K.
N1 - Funding Information:
We would like to thank Richard Scheussler, PhD, for his assistance with the statistical analysis and Glenn Foster, RRT, Rich Nagel, RRT, and Marci Bailey, RN, for their assistance in acquiring the data used in this manuscript. This work was supported by NIH Grant RO1 HL64869.
PY - 2005/12
Y1 - 2005/12
N2 - Background. Left ventricular three-dimensional nonlinear systolic strain determinations have potential to detect small decrements in ventricular function in patients with aortic insufficiency before and after aortic valve replacement. Methods. Magnetic resonance imaging with tissue-tagging was performed on 42 normal volunteers and 14 patients with chronic aortic insufficiency both before and 28 ± 11 months after aortic valve replacement. Preoperative and postoperative left ventricular volume, dimensions and ejection fraction were determined for all subjects. Left ventricular systolic radial, circumferential, longitudinal, and minimum principal strain were calculated for six left ventricular regions. Results. After aortic valve replacement, left ventricular volume and dimensions decreased significantly (p < 0.001) and ejection fraction increased nonsignificantly (p = 0.096). Strain values in preoperative aortic insufficiency patients did not differ significantly from controls. At an average of 28 ± 11 months postoperatively, however, regional three-dimensional minimum principal and longitudinal strain was decreased in all six ventricular regions as well as globally (p < 0.03) compared with normal control values. Circumferential strain was significantly decreased globally and in all but two regions (p < 0.03). Conclusions. These magnetic resonance imaging-based techniques are sensitive enough to detect a previously unrecognized, significant decrease in both global and regional three-dimensional left ventricular systolic strain 2 years after aortic valve replacement for minimally symptomatic chronic aortic insufficiency despite improvement in ejection fraction and a decrease in left ventricular size. The reasons for a significant decline in left ventricular systolic strain after successful aortic valve replacement in minimally symptomatic chronic aortic insufficiency patients are not clear and warrant further investigation.
AB - Background. Left ventricular three-dimensional nonlinear systolic strain determinations have potential to detect small decrements in ventricular function in patients with aortic insufficiency before and after aortic valve replacement. Methods. Magnetic resonance imaging with tissue-tagging was performed on 42 normal volunteers and 14 patients with chronic aortic insufficiency both before and 28 ± 11 months after aortic valve replacement. Preoperative and postoperative left ventricular volume, dimensions and ejection fraction were determined for all subjects. Left ventricular systolic radial, circumferential, longitudinal, and minimum principal strain were calculated for six left ventricular regions. Results. After aortic valve replacement, left ventricular volume and dimensions decreased significantly (p < 0.001) and ejection fraction increased nonsignificantly (p = 0.096). Strain values in preoperative aortic insufficiency patients did not differ significantly from controls. At an average of 28 ± 11 months postoperatively, however, regional three-dimensional minimum principal and longitudinal strain was decreased in all six ventricular regions as well as globally (p < 0.03) compared with normal control values. Circumferential strain was significantly decreased globally and in all but two regions (p < 0.03). Conclusions. These magnetic resonance imaging-based techniques are sensitive enough to detect a previously unrecognized, significant decrease in both global and regional three-dimensional left ventricular systolic strain 2 years after aortic valve replacement for minimally symptomatic chronic aortic insufficiency despite improvement in ejection fraction and a decrease in left ventricular size. The reasons for a significant decline in left ventricular systolic strain after successful aortic valve replacement in minimally symptomatic chronic aortic insufficiency patients are not clear and warrant further investigation.
UR - http://www.scopus.com/inward/record.url?scp=28344438578&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2005.05.095
DO - 10.1016/j.athoracsur.2005.05.095
M3 - Article
C2 - 16305868
AN - SCOPUS:28344438578
SN - 0003-4975
VL - 80
SP - 2186
EP - 2192
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 6
ER -