Distribution and Prognostic Significance of Left Ventricular Global Longitudinal Strain in Asymptomatic Significant Aortic Stenosis: An Individual Participant Data Meta-Analysis

Magne, Julien; Cosyns, Bernard; Popescu, Bogdan Alexandru; Carstensen, Helle Gervig; Dahl, Jordi Sanchez; Desai, Milind Y.; Kearney, Leighton; Lancellotti, Patrizio; Marwick, Thomas H.; Sato, Kimi; Takeuchi, Masaaki; Zito, Concetta; Casalta, Anne-Claire; Mohty, Dania; Pierard, Luc; Habib, Gilbert; Donal, Erwan; LTSI, Inserm

doi:10.1016/j.jcmg.2018.11.005

Article (Scientific journals)

Distribution and Prognostic Significance of Left Ventricular Global Longitudinal Strain in Asymptomatic Significant Aortic Stenosis: An Individual Participant Data Meta-Analysis

Magne, Julien; Cosyns, Bernard; Popescu, Bogdan Alexandru et al.

2019 • In JACC. Cardiovascular Imaging, 12 (1), p. 84-92

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https://hdl.handle.net/2268/245620

DOI
10.1016/j.jcmg.2018.11.005

PubMed
30621997

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Abstract :

[en] Objectives: In this individual participant data meta-analysis on left ventricular global longitudinal strain (LVGLS), our objective was to: 1) describe its distribution; 2) identify the most predictive cutoff values; and 3) assess its impact on mortality in asymptomatic patients with significant aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF). Background: The evidence supporting the prognostic role of LVGLS in asymptomatic patients with AS has been obtained from several relatively small studies. Methods: A literature search was performed for studies published between 2005 and 2017 without language restriction according to the following criteria: “aortic stenosis” AND “longitudinal strain.” The corresponding authors of selected studies were contacted and invited to share their data that we computerized in a specific database. The primary endpoint was all-cause mortality. Results: Among the 10 studies included, 1,067 asymptomatic patients with significant AS and LVEF >50% were analyzed. The median of LVGLS was 16.2% (from 5.6% to 30.1%). There were 91 deaths reported during follow-up with median of 1.8 (0.9 to 2.8) years, resulting in a pooled crude mortality rate of 8.5%. The LVGLS performed well in the prediction of death (area under the curve: 0.68). The best cutoff value identified was LVGLS of 14.7% (sensitivity, 60%; specificity, 70%). Using random effects model, the risk of death for patients with LVGLS <14.7% is multiplied by >2.5 (hazard ratio: 2.62; 95% confidence interval: 1.66 to 4.13; p < 0.0001), without significant heterogeneity between studies (I2 = 18.3%; p = 0.275). The relationship between LVGLS and mortality remained significant in patients with LVEF ≥60% (p = 0.001). Conclusions: This individual participant data meta-analysis demonstrates that in asymptomatic patients with significant AS and normal LVEF, impaired LVGLS is associated with reduced survival. These data emphasize the potential usefulness of LVGLS for risk stratification and management of these patients. © 2018 American College of Cardiology Foundation

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

Magne, Julien; CHU Limoges, Hôpital Dupuytren, Service Cardiologie, INSERM 1094, Limoges, France

Cosyns, Bernard; UZ Brussel-CVHZ, Brussels, Belgium

Popescu, Bogdan Alexandru; University of Medicine and Pharmacy “Carol Davila”—Euroecolab, Institute of Cardiovascular Diseases “Prof. Dr. C. C. Iliescu,”, Bucharest, Romania

Carstensen, Helle Gervig; Department of Cardiology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark

Dahl, Jordi Sanchez; Department of Cardiology, Odense University Hospital, Odense, Denmark

Desai, Milind Y.; Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, United States

Kearney, Leighton; Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia

Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation

Marwick, Thomas H.; Baker Heart and Diabetes Institute, Melbourne, Australia

Sato, Kimi; Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

More authors (8 more)

Language :

English

Title :

Distribution and Prognostic Significance of Left Ventricular Global Longitudinal Strain in Asymptomatic Significant Aortic Stenosis: An Individual Participant Data Meta-Analysis

Publication date :

2019

Journal title :

JACC. Cardiovascular Imaging

ISSN :

1936-878X

eISSN :

1876-7591

Publisher :

Elsevier Inc.

Volume :

Issue :

Pages :

84-92

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 05 March 2020

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Bibliography

Nishimura, R.A., Otto, C.M., Bonow, R.O., et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 70 (2017), 252–289.
Baumgartner, H., Falk, V., Bax, J.J., et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J 38 (2017), 2739–2791.
Dahl, J.S., Eleid, M.F., Michelena, H.I., et al. Effect of left ventricular ejection fraction on postoperative outcome in patients with severe aortic stenosis undergoing aortic valve replacement. Circ Cardiovasc Imaging, 8, 2015, 10.1161/CIRCIMAGING.114.002917.
Dweck, M.R., Joshi, S., Murigu, T., et al. Midwall fibrosis is an independent predictor of mortality in patients with aortic stenosis. J Am Coll Cardiol 58 (2011), 1271–1279.
Chin, C.W.L., Everett, R.J., Kwiecinski, J., et al. Myocardial fibrosis and cardiac decompensation in aortic stenosis. J Am Coll Cardiol Img 10 (2017), 1320–1333.
Barone-Rochette, G., Pierard, S., de Meester de, R.C., et al. Prognostic significance of LGE by CMR in aortic stenosis patients undergoing valve replacement. J Am Coll Cardiol 64 (2014), 144–154.
Bull, S., White, S.K., Piechnik, S.K., et al. Human non-contrast T1 values and correlation with histology in diffuse fibrosis. Heart Br Card Soc 99 (2013), 932–937.
Lee, H., Park, J.-B., Yoon, Y.E., et al. Noncontrast myocardial T1 mapping by cardiac magnetic resonance predicts outcome in patients with aortic stenosis. J Am Coll Cardiol Img 11 (2018), 974–983.
Treibel, T.A., Kozor, R., Schofield, R., et al. Reverse myocardial remodeling following valve replacement in patients with aortic stenosis. J Am Coll Cardiol 71 (2018), 860–871.
Ito, S., Miranda, W.R., Nkomo, V.T., et al. Reduced left ventricular ejection fraction in patients with aortic stenosis. J Am Coll Cardiol 71 (2018), 1313–1321.
Weidemann, F., Herrmann, S., Stork, S., et al. Impact of myocardial fibrosis in patients with symptomatic severe aortic stenosis. Circulation 120 (2009), 577–584.
Mele, D., Censi, S., La Corte, R., et al. Abnormalities of left ventricular function in asymptomatic patients with systemic sclerosis using Doppler measures of myocardial strain. J Am Soc Echocardiogr 21 (2008), 1257–1264.
Azevedo, C.F., Nigri, M., Higuchi, M.L., et al. Prognostic significance of myocardial fibrosis quantification by histopathology and magnetic resonance imaging in patients with severe aortic valve disease. J Am Coll Cardiol 56 (2010), 278–287.
Stewart, L.A., Clarke, M., Rovers, M., et al. Preferred reporting items for systematic review and meta-analyses of individual participant data: the PRISMA-IPD Statement. JAMA 313 (2015), 1657–1665.
Pencina, M.J., D'Agostino, R.B., Demler, O.V., Novel metrics for evaluating improvement in discrimination: net reclassification and integrated discrimination improvement for normal variables and nested models. Stat Med 31 (2012), 101–113.
Sato, K., Seo, Y., Ishizu, T., et al. Prognostic value of global longitudinal strain in paradoxical low-flow, low-gradient severe aortic stenosis with preserved ejection fraction. Circ J Off J Jpn Circ Soc 78 (2014), 2750–2759.
Yingchoncharoen, T., Gibby, C., Rodriguez, L.L., Grimm, R.A., Marwick, T.H., Association of myocardial deformation with outcome in asymptomatic aortic stenosis with normal ejection fraction. Circ Cardiovasc Imaging 5 (2012), 719–725.
Dahl, J.S., Videbæk, L., Poulsen, M.K., Rudbæk, T.R., Pellikka, P.A., Møller, J.E., Global strain in severe aortic valve stenosis: relation to clinical outcome after aortic valve replacement. Circ Cardiovasc Imaging 5 (2012), 613–620.
Ng, A.C., Delgado, V., Bertini, M., et al. Alterations in multidirectional myocardial functions in patients with aortic stenosis and preserved ejection fraction: a two-dimensional speckle tracking analysis. Eur Heart J 32 (2011), 1542–1550.
Takeda, S., Rimington, H., Smeeton, N., Chambers, J., Long axis excursion in aortic stenosis. Heart 86 (2001), 52–56.
Castaño, A., Narotsky, D.L., Hamid, N., et al. Unveiling transthyretin cardiac amyloidosis and its predictors among elderly patients with severe aortic stenosis undergoing transcatheter aortic valve replacement. Eur Heart J 38 (2017), 2879–2887.
Mor-Avi, V., Lang, R.M., Badano, L.P., et al. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. Eur J Echocardiogr J Work Group Echocardiogr Eur Soc Cardiol 12 (2011), 167–205.
Galli, E., Lancellotti, P., Sengupta, P.P., Donal, E., LV mechanics in mitral and aortic valve diseases: value of functional assessment beyond ejection fraction. J Am Coll Cardiol Img 7 (2014), 1151–1166.
Donal, E., Thebault, C., O'Connor, K., et al. Impact of aortic stenosis on longitudinal myocardial deformation during exercise. Eur J Echocardiogr 12 (2011), 235–241.
Farsalinos, K.E., Daraban, A.M., Ünlü S., Thomas, J.D., Badano, L.P., Voigt, J.-U., Head-to-head comparison of global longitudinal strain measurements among nine different vendors: the EACVI/ASE Inter-Vendor Comparison Study. J Am Soc Echocardiogr 28 (2015), 1171–1181.
Mirea, O., Pagourelias, E.D., Duchenne, J., et al. Variability and reproducibility of segmental longitudinal strain measurement: a report from the EACVI-ASE Strain Standardization Task Force. J Am Coll Cardiol Img 11 (2018), 15–24.
Kafa, R., Kusunose, K., Goodman, A.L., et al. Association of abnormal postoperative left ventricular global longitudinal strain with outcomes in severe aortic stenosis following aortic valve replacement. JAMA Cardiol 1 (2016), 494–496.
Flett, A.S., Hayward, M.P., Ashworth, M.T., et al. Equilibrium contrast cardiovascular magnetic resonance for the measurement of diffuse myocardial fibrosis: preliminary validation in humans. Circulation 122 (2010), 138–144.
Huded, C.P., Masri, A., Kusunose, K., et al. Outcomes in asymptomatic severe aortic stenosis with preserved ejection fraction undergoing rest and treadmill stress echocardiography. J Am Heart Assoc, 7, 2018, 10.1161/JAHA.117.007880.
Marechaux, S., Hachicha, Z., Bellouin, A., et al. Usefulness of exercise-stress echocardiography for risk stratification of true asymptomatic patients with aortic valve stenosis. Eur Heart J 31 (2010), 1390–1397.
Lauer, M.S., Blackstone, E.H., Young, J.B., Topol, E.J., Cause of death in clinical research: time for a reassessment?. J Am Coll Cardiol 34 (1999), 618–620.
Lancellotti, P., Donal, E., Magne, J., et al. Risk stratification in asymptomatic moderate to severe aortic stenosis: the importance of the valvular, arterial and ventricular interplay. Heart 96 (2010), 1364–1371.
Zito, C., Salvia, J., Cusma-Piccione, M., et al. Prognostic significance of valvuloarterial impedance and left ventricular longitudinal function in asymptomatic severe aortic stenosis involving three-cuspid valves. Am J Cardiol 108 (2011), 1463–1469.
Kearney, L.G., Lu, K., Ord, M., et al. Global longitudinal strain is a strong independent predictor of all-cause mortality in patients with aortic stenosis. Eur Heart J Cardiovasc Imaging 13 (2012), 827–833.
Kusunose, K., Goodman, A., Parikh, R., et al. Incremental prognostic value of left ventricular global longitudinal strain in patients with aortic stenosis and preserved ejection fraction. Circ Cardiovasc Imaging 7 (2014), 938–945.
Carstensen, H.G., Larsen, L.H., Hassager, C., Kofoed, K.F., Jensen, J.S., Mogelvang, R., Basal longitudinal strain predicts future aortic valve replacement in asymptomatic patients with aortic stenosis. Eur Heart J Cardiovasc Imaging 17 (2016), 283–292.
Nagata, Y., Takeuchi, M., Wu, V.C.-C., et al. Prognostic value of LV deformation parameters using 2D and 3D speckle-tracking echocardiography in asymptomatic patients with severe aortic stenosis and preserved LV ejection fraction. J Am Coll Cardiol Img 8 (2015), 235–245.
Salaun, E., Casalta, A.-C., Donal, E., et al. Apical four-chamber longitudinal left ventricular strain in patients with aortic stenosis and preserved left ventricular ejection fraction: analysis related with flow/gradient pattern and association with outcome. Eur Heart J Cardiovasc Imaging 19 (2018), 868–878.