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Dissecting Myocardial Mechanics in Patients With Severe Aortic Stenosis: 2-Dimensional vs 3-Dimensional–Speckle Tracking Echocardiography
Hector R. Villarraga
Mayo Clinic Minnesota
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3675-6948
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The most recent version of this article is available here.
Background: Aortic valve stenosis (AS) commonly causes left ventricular (LV) pressure overload; thus, identifying patients with adverse remodeling/early LV dysfunction is critical. We compared 2-dimensional (2D) to 3-dimensional (3D) echocardiographic measures of LV myocardial deformation in patients with severe AS and studied the relation of LV preload and afterload (Zva) to myocardial deformation.
Methods: We prospectively included 168 symptomatic patients (72±12 years) with severe AS and ejection fractions ≥50%. Strain parameters from those patients were compared with normal values found in the literature. 3D full-volume and 2D images were analyzed for global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), systolic strain rate (SRs), basal rotation (Rotmax-B), apical rotation (Rotmax-A), and peak systolic twist (Twistmax).
Results: 2D–GLS and 2D–GCS decreased significantly compared with normal values (P˂.001 and P=.02, respectively); 2D Rotmax-B and Twistmax increased (P˂.001 vs normal values). Agreement between 2D–GLS and 3D–GLS by concordance correlation coefficient was 0.49 (95% CI, 0.39-0.57) in patients with AS. Both 2D– and 3D–GLS correlated with valvulo-arterial impedance (Zva) (r=0.34, P<.001; and r=0.23, P=.003, respectively).
Conclusion: In patients with severe AS, GLS and GCS decreased, and basal rotation and twist increased to maintain LV ejection fraction. 2D– and 3D–GLS had a relatively fair agreement. Both 2D– and 3D–GLS correlated modestly with Zva.
Keywords
aortic stenosis; echocardiography; stage B heart failure; strain; 3 dimensional–speckle-tracking echocardiography; valvulo-arterial impedance
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On 08 Jan, 2020
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On 07 Jan, 2020
Editor invited
On 07 Jan, 2020
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Editorial decision: Minor revision
On 06 Jan, 2020
Review #2 received
Received 28 Dec, 2019
Reviewers invited
Invitations sent on 09 Dec, 2019
Reviewer #1 agreed
On 09 Dec, 2019
Reviewer #2 agreed
On 09 Dec, 2019
Review #1 received
Received 09 Dec, 2019
Editor assigned
On 08 Dec, 2019
Submission checks complete
On 07 Dec, 2019
Editor invited
On 07 Dec, 2019
Version 1
Posted 10 Sep, 2019
No comments provided
Editorial decision: Major revision
On 28 Sep, 2019
Review #1 received
Received 24 Sep, 2019
Review #2 received
Received 16 Sep, 2019
Reviewer #2 agreed
On 11 Sep, 2019
Reviewers invited
Invitations sent on 10 Sep, 2019
Reviewer #1 agreed
On 10 Sep, 2019
Editor assigned
On 09 Sep, 2019
Submission checks complete
On 08 Sep, 2019
Editor invited
On 05 Sep, 2019
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Subject Areas
Cardiac & Cardiovascular Systems
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This preprint is under consideration at BMC Cardiovascular Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Dissecting Myocardial Mechanics in Patients With Severe Aortic Stenosis: 2-Dimensional vs 3-Dimensional–Speckle Tracking Echocardiography
Hector R. Villarraga
Mayo Clinic Minnesota
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3675-6948
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
No community comments so far
Editor assigned
On 08 Jan, 2020
Submission checks complete
On 07 Jan, 2020
Editor invited
On 07 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 06 Jan, 2020
Review #2 received
Received 28 Dec, 2019
Reviewers invited
Invitations sent on 09 Dec, 2019
Reviewer #1 agreed
On 09 Dec, 2019
Reviewer #2 agreed
On 09 Dec, 2019
Review #1 received
Received 09 Dec, 2019
Editor assigned
On 08 Dec, 2019
Submission checks complete
On 07 Dec, 2019
Editor invited
On 07 Dec, 2019
Version 1
Posted 10 Sep, 2019
No comments provided
Editorial decision: Major revision
On 28 Sep, 2019
Review #1 received
Received 24 Sep, 2019
Review #2 received
Received 16 Sep, 2019
Reviewer #2 agreed
On 11 Sep, 2019
Reviewers invited
Invitations sent on 10 Sep, 2019
Reviewer #1 agreed
On 10 Sep, 2019
Editor assigned
On 09 Sep, 2019
Submission checks complete
On 08 Sep, 2019
Editor invited
On 05 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The most recent version of this article is available here.
Background: Aortic valve stenosis (AS) commonly causes left ventricular (LV) pressure overload; thus, identifying patients with adverse remodeling/early LV dysfunction is critical. We compared 2-dimensional (2D) to 3-dimensional (3D) echocardiographic measures of LV myocardial deformation in patients with severe AS and studied the relation of LV preload and afterload (Zva) to myocardial deformation.
Methods: We prospectively included 168 symptomatic patients (72±12 years) with severe AS and ejection fractions ≥50%. Strain parameters from those patients were compared with normal values found in the literature. 3D full-volume and 2D images were analyzed for global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), systolic strain rate (SRs), basal rotation (Rotmax-B), apical rotation (Rotmax-A), and peak systolic twist (Twistmax).
Results: 2D–GLS and 2D–GCS decreased significantly compared with normal values (P˂.001 and P=.02, respectively); 2D Rotmax-B and Twistmax increased (P˂.001 vs normal values). Agreement between 2D–GLS and 3D–GLS by concordance correlation coefficient was 0.49 (95% CI, 0.39-0.57) in patients with AS. Both 2D– and 3D–GLS correlated with valvulo-arterial impedance (Zva) (r=0.34, P<.001; and r=0.23, P=.003, respectively).
Conclusion: In patients with severe AS, GLS and GCS decreased, and basal rotation and twist increased to maintain LV ejection fraction. 2D– and 3D–GLS had a relatively fair agreement. Both 2D– and 3D–GLS correlated modestly with Zva.
Figure 1
Figure 2
Figure 3