Article (Scientific journals)
Impact of aortic stenosis on layer-specific longitudinal strain: relationship with symptoms and outcome
Ilardi, F.; MARCHETTA, Stella; MARTINEZ, Christophe et al.
2020In European Heart Journal. Cardiovascular Imaging, 21 (4), p. 408-416
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Abstract :
[en] AIMS: The present study sought to assess the impact of aortic stenosis (AS) on myocardial function as assessed by layer-specific longitudinal strain (LS) and its relationship with symptoms and outcome. METHODS AND RESULTS: We compared 211 patients (56% males, mean age 73 ± 12 years) with severe AS and left ventricular ejection fraction (LVEF) ≥50% (114 symptomatic, 97 asymptomatic) with 50 controls matched for age and sex. LS was assessed from endocardium, mid-myocardium, and epicardium by 2D speckle-tracking echocardiography. Despite similar LVEF, multilayer strain values were significantly lower in symptomatic patients, compared to asymptomatic and controls [global LS: 17.9 ± 3.4 vs. 19.1 ± 3.1 vs. 20.7 ± 2.1%; endocardial LS: 20.1 ± 4.9 vs. 21.7 ± 4.2 vs. 23.4 ± 2.5%; epicardial LS: 15.8 ± 3.1 vs. 16.8 ± 2.8 vs. 18.3 ± 1.8%; P < 0.001 for all]. On multivariable logistic regression analysis, endocardial LS was independently associated to symptoms (P = 0.012), together with indexed left atrial volume (P = 0.006) and LV concentric remodelling (P = 0.044). During a mean follow-up of 22 months, 33 patients died of a cardiovascular event. On multivariable Cox-regression analysis, age (P = 0.029), brain natriuretic peptide values (P = 0.003), LV mass index (P = 0.0065), LV end-systolic volume (P = 0.012), and endocardial LS (P = 0.0057) emerged as independently associated with cardiovascular death. The best endocardial LS values associated with outcome was 20.6% (sensitivity 70%, specificity 52%, area under the curve = 0.626, P = 0.022). Endocardial LS (19.1 ± 3.3 vs. 20.7 ± 3.3, P = 0.02) but not epicardial LS (15.2 ± 2.8 vs. 15.9 ± 2.5, P = 0.104) also predicted the outcome in patients who were initially asymptomatic. CONCLUSION: In patients with severe AS, LS impairment involves all myocardial layers and is more prominent in the advanced phases of the disease, when the symptoms occur. In this setting, the endocardial LS is independently associated with symptoms and patient outcome. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Ilardi, F.;  Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman ,Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium, Department of Advanced Biomedical Sciences, University Federico II of Via S. Pansini, Naples, 80131, Italy
MARCHETTA, Stella ;  Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des soins intensifs
MARTINEZ, Christophe ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Cardiologie interventionnelle
SPRYNGER, Muriel ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Angéiologie
ANCION, Arnaud  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Insuffisance cardiaque - Transplantation
Manganaro, R.;  Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman ,Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
Sugimoto, T.;  Department of Clinical Laboratory, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
Tsugu, T.;  Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman ,Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium, Department of Cardiology, School of Medicine, Keio UniversityTokyo 160-8582, Japan
Postolache, Adriana ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de cardiologie
PIETTE, Caroline ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de cardiologie
Cicenia, M.;  Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman ,Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
Esposito, Giovanni ;  Université de Liège - ULiège > HEC Liège : UER > UER Management : Sustainable Strategy
Galderisi, M.;  Department of Advanced Biomedical Sciences, University Federico II of Via S. Pansini, Naples, 80131, Italy
Oury, Cécile  ;  Université de Liège - ULiège > Cardiovascular Sciences-Cardiology
Dulgheru, Raluca Elena ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Lancellotti, Patrizio  ;  Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
More authors (6 more) Less
Language :
English
Title :
Impact of aortic stenosis on layer-specific longitudinal strain: relationship with symptoms and outcome
Publication date :
2020
Journal title :
European Heart Journal. Cardiovascular Imaging
ISSN :
2047-2404
eISSN :
2047-2412
Publisher :
NLM (Medline)
Volume :
21
Issue :
4
Pages :
408-416
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 13 February 2021

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