Left ventricular torsional dynamics in aortic stenosis: relationship between left ventricular untwisting and filling pressures. A two-dimensional speckle tracking study.
Popescu, Bogdan Alexandru; Calin, Andreea; Beladan, Carmen C.et al.
2010 • In European Journal of Echocardiography, 11 (5), p. 406-13
[en] AIMS: The contribution of left ventricular (LV) untwisting to LV suction and early-diastolic filling was previously demonstrated, but this was not yet tested in patients with aortic stenosis (AS). We sought to assess the relationship between LV untwisting and LV filling pressures in patients with severe AS and normal left ventricular ejection fraction (LVEF) using speckle tracking echocardiography. METHODS AND RESULTS: Sixty-one consecutive patients (66 +/- 9 years) with severe AS, preserved LVEF (63 +/- 6%), and 40 normal subjects (47 +/- 12 years) were prospectively enrolled. A comprehensive echocardiographic examination was performed in all. LV rotation and twisting were assessed using speckle tracking echocardiography. Peak apical back rotation rate, peak LV untwisting rate, and time intervals from QRS onset (ECG) to each of them were measured. Brain natriuretic peptide (BNP) levels were determined in 30 patients. Patients with AS were older than normal subjects (P < 0.001). LV mass, LA volume, LV filling pressures as well as peak apical back rotation rate and time to peak apical back rotation rate were increased in patients (P < 0.05 for all). In patients with AS, both time to peak LV untwisting rate and time to peak apical back rotation rate were significantly related to E/E' ratio and to BNP levels (P < 0.04 for all). CONCLUSION: In patients with severe AS and preserved LVEF, there is a significant relationship between LV untwisting and LV filling pressures, suggesting a role for impaired LV untwisting in the pathophysiology of diastolic dysfunction in this setting.
Left ventricular torsional dynamics in aortic stenosis: relationship between left ventricular untwisting and filling pressures. A two-dimensional speckle tracking study.
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Bibliography
Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE et al. Clinical factors associated with calcific aortic valve disease: Cardiovascular Health Study. J Am Coll Cardiol 1997;29:630-634
Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. J Am Coll Cardiol 2006;48:e1-e148.
Vahanian A, Baumgartner H, Bax J, Butchart E, Dion R, Filippatos G et al. Guidelines on the management of valvular heart disease The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J 2007;28:230-268
Bruch C, Stypmann J, Grude M, Gradaus R, Breithardt G, Wichter T. Tissue Doppler imaging in patients with moderate to severe aortic valve stenosis: clinical usefulness and diagnostic accuracy. Am Heart J 2004;148:696-702.
Dineen E, Brent BN. Aortic valve stenosis: comparison of patients with to those without chronic congestive heart failure. Am J Cardiol 1986;57:419-422
Kowalski M, Herbots L, Weidemann F, Breithardt O, Strotmann J, Davidavicius G et al. One-dimensional ultrasonic strain and strain rate imaging: a new approach to quantitation of regional myocardial function in patients with aortic stenosis. Ultrasound Med Biol 2003;29:1085-1092
Poulsen SH, Søgaard P, Nielsen-Kudsk JE, Egeblad H. Recovery of left ventricular systolic longitudinal strain after valve replacement in aortic stenosis and relation to natriuretic peptides. J Am Soc Echocardiogr 2007;20:877-884
Sengupta PP, Tajik AJ, Chandrasekaran K, Khandheria BK. Twist mechanics of the left ventricle: principles and application. J Am Coll Cardiol Img 2008;1:366-376
Nagel E, Stuber M, Burkhard B, Fischer SE, Scheidegger MB, Boesiger P et al. Cardiac rotation and relaxation in patients with aortic valve stenosis. Eur Heart J 2000;21:582-589
Stuber M, Scheidegger MB, Fischer SE, Nagel E, Steinemann F, Hess OM et al. Alterations in the local myocardial motion pattern in patients suffering from pressure overload due to aortic stenosis. Circulation 1999;100:361-368
Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. Eur J Echocardiogr 2006;7:79-108.
Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 1986;57:450-458
ZoghbiWA, Farmer KL, Soto JG, Nelson JG, Quinones MA. Accurate noninvasive quantification of stenotic aortic valve area by Doppler echocardiography. Circulation 1986;73:452-459
Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfield MM et al. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study. Circulation 2000;102:1788-1794
van Dalen BM, Vletter WB, Soliman OI, ten Cate FJ, Geleijnse ML. Importance of transducer position in the assessment of apical rotation by speckle tracking echocardiography. J Am Soc Echocardiogr 2008;21:895-898
Notomi Y, Lysyansky P, Setser RM, Shiota T, Popovic ZB, Martin-Miklovic MG et al. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. J Am Coll Cardiol 2005;45:2034-2041
Popescu BA, Beladan CC, Calin A, Muraru D, Deleanu D, Rosca M et al. Left ventricular remodelling and torsional dynamics in dilated cardiomyopathy: reversed apical rotation as a marker of disease severity. Eur J Heart Fail 2009;11:945-951
Burns AT, La Gerche A, MacIsaac AI, Prior DL. Augmentation of left ventricular torsion with exercise is attenuated with age. J Am Soc Echocardiogr 2008;21: 315-320
Ingels NB, Daughters GT II, Stinson EB, Alderman EL. Measurement of midwall myocardial dynamics in intact man by radiography of surgically implanted markers. Circulation 1975;52:859-867
Buchalter MB, Weiss JL, Rogers WJ et al. Noninvasive quantification of left ventricular rotational deformation in normal humans using magnetic resonance imaging myocardial tagging. Circulation 1990;81:1236-1244
Vincent WR, Buckberg GD, Hoffman JI. Left ventricular subendocardial ischemia in severe valvar and supravalvar aortic stenosis. A common mechanism. Circulation 1974;49:326-333
Ingels NB Jr, Hansen DE, Daughters GT II, Stinson EB, Alderman EL, Miller DC. Relation between longitudinal, circumferential, and oblique shortening and torsional deformation in the left ventricle of the transplanted human heart. Circ Res 1989;64:915-927
Helle-Valle T, Crosby J, Edvardsen T, Lyseggen E, Amundsen BH, Smith HJ et al. New noninvasive method for assessment of left ventricular rotation: speckle tracking echocardiography. Circulation 2005;112:3149-3156
Sandstede JW, Johnson T, Harre K, Beer M, Hofmann S, Pabst T et al. Cardiac systolic rotation and contraction before and after valve replacement for aortic stenosis: a myocardial tagging study using MR imaging. Am J Roentgenol 2002;178: 953-958
Notomi Y, Martin-Miklovic MG, Oryszak SJ, Shiota T, Deserranno D et al. Enhanced ventricular untwisting during exercise. A mechanistic manifestation of elastic recoil described by Doppler tissue imaging. Circulation 2006;113:2524-2533
Hess OM, Villari B, Krayenbuehl HP. Diastolic dysfunction in aortic stenosis. Circulation 1993;87:IV73-IV76.
Archer SL, Mike DK, Hetland MB, Kostamo KL, Shafer RB, Chesler E. Usefulness of mean aortic valve gradient and left ventricular diastolic filling pattern for distinguishing symptomatic from asymptomatic patients. Am J Cardiol 1994;73:275-281
Somaratne JB, Whalley GA, Poppe KK, Gamble GD, Doughty RN. Pseudonormal mitral filling is associated with similarly poor prognosis as restrictive filling in patients with heart failure and coronary heart disease: a systematic review and meta-analysis of prospective studies. J Am Soc Echocardiogr 2009;22:494-498
Whalley GA, Gamble GD, Doughty RN. The prognostic significance of restrictive diastolic filling associated with heart failure: a meta-analysis. Int J Cardiol 2007;116: 70-77
Gjertsson P, Caidahl K, Farasati M, Oden A, Bech-Hanssen O. Preoperative moderate to severe diastolic dysfunction: a novel Doppler echocardiographic longterm prognostic factor in patients with severe aortic stenosis. J Thorac Cardiovasc Surg 2005;129:890-896
Nagueh SF, Middleton KJ, Kopelen HA, Zoghbi WA, Quinones MA. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol 1997;30:1527-1533
Burgess MI, Jenkins C, Sharman JE, Marwick TH. Diastolic stress echocardiography: hemodynamic validation and clinical significance of estimation of ventricular filling pressure with exercise. J Am Coll Cardiol 2006;47:1891-1900
Hillis GS, Moller JE, Pellikka PA, Gersh BJ, Wright RS, Ommen SR et al. Noninvasive estimation of left ventricular filling pressure by E/E0 is a powerful predictor of survival after acute myocardial infarction. J Am Coll Cardiol 2004;43:360-367
Dokainish H, Zoghbi WA, Lakkis NM, Ambriz E, Patel R, Quinones MA et al. Incremental predictive power of B-type natriuretic peptide and tissue Doppler echocardiography in the prognosis of patients with congestive heart failure. J Am Coll Cardiol 2005;45:1223-1226
Wang M, Yip GW, Wang AY, Zhang Y, Ho PY, Tse MK et al. Tissue Doppler imaging provides incremental prognostic value in patients with systemic hypertension and left ventricular hypertrophy. J Hypertens 2005;23:183-191
Okura H, Takada Y, Kubo T, Iwata K, Mizoguchi S, Taguchi H et al. Tissue Doppler-derived index of left ventricular filling pressure, E/E0 , predicts survival of patients with non-valvular atrial fibrillation. Heart 2006;92:1248-1252
Bruch C, Klem I, Breithardt G, Wichter T, Gradaus R. Diagnostic usefulness and prognostic implications of the mitral E/E0 ratio in patients with heart failure and severe secondary mitral regurgitation. Am J Cardiol 2007;100:860-865
Poh KK, ChanMY, Yang H, YongQW, Chan YH, Ling LH. Prognostication of valvular aortic stenosis using tissue Doppler echocardiography: underappreciated importance of late diastolic mitral annular velocity. J Am Soc Echocardiogr 2008;21:475-481
Dalsgaard M, Kjaergaard J, Pecini R, Iversen KK, Køber L, Moller JE et al. Left ventricular filling pressure estimation at rest and during exercise in patients with severe aortic valve stenosis: comparison of echocardiographic and invasive measurements. J Am Soc Echocardiogr 2009;22:343-349
Prasad N, Bridges AB, Lang CC, Clarkson PB, MacLeod C, Pringle TH et al. Brain natriuretic peptide concentrations in patients with aortic stenosis. Am Heart J 1997;133:477-479
QiW, Mathisen P, Kjekshus J, Simonsen S, Bjørnerheim R, Endresen K et al. Natriuretic peptides in patients with aortic stenosis. Am Heart J 2001;142:725-732
Gerber IL, Stewart RAH, Legget ME, West TM, French RL, Sutton TM et al. Increased plasma natriuretic peptides reflect symptom onset in aortic stenosis. Circulation 2003;107:1884-1890
Bergler-Klein J, Klaar U, Heger M, Rosenhek R, Mundigler G, Gabriel H et al. Natriuretic peptides predict symptom-free survival and postoperative outcome in severe aortic stenosis. Circulation 2004;109:2302-2308
Omran H, Schmidt H, Hackenbroch M, Illien S, Bernhardt P, von der Recke G et al. Silent and apparent cerebral embolism after retrograde catheterisation of the aortic valve in valvular stenosis: a prospective, randomised study. Lancet 2003;361:1241-1246 (Pubitemid 36428577)
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.