Author + information
- Received August 3, 2010
- Revision received November 9, 2010
- Accepted November 15, 2010
- Published online March 1, 2011.
- Niels Thue Olsen, MD, PhD⁎,⁎ (, )
- Peter Sogaard, MD, DMSc⁎,
- Henrik B.W. Larsson, MD, DMSc, PhD†,
- Jens Peter Goetze, MD, DMSc‡,
- Christian Jons, MD, PhD⁎,
- Rasmus Mogelvang, MD, PhD⁎,
- Olav W. Nielsen, MD, DMSc§ and
- Thomas Fritz-Hansen, MD⁎
- ↵⁎Reprint requests and correspondence:
Dr. Niels Thue Olsen, Department of Cardiology, Gentofte University Hospital, Copenhagen, Niels Andersens Vej 65, DK-2900 Hellerup, Denmark
Objectives The aim of this study was to test myocardial deformation imaging using speckle-tracking echocardiography for predicting outcomes in chronic aortic regurgitation.
Background In chronic aortic regurgitation, left ventricular (LV) dysfunction must be detected early to allow timely surgery. Speckle-tracking echocardiography has been proposed for this purpose, but the clinical value of this method in aortic regurgitation has not been established.
Methods A longitudinal study was performed in 64 patients with moderate to severe aortic regurgitation. Thirty-five patients were managed conservatively with frequent clinical visits and sequential echocardiography and followed for an average of 19 ± 8 months, while 29 patients underwent surgery for the valve lesion and were followed for 6 months post-operatively. Baseline LV function by speckle-tracking and conventional echocardiography was compared with impaired outcome after surgery (defined as persisting symptoms or persisting LV dilation [LV end-diastolic volume index ≥87 ml/m2] or dysfunction [LV ejection fraction <50%]) and with disease progression during conservative management (defined as development of symptoms, increase in LV volume >15%, or decrease in LV ejection fraction >10%).
Results Reduced myocardial systolic strain, systolic strain rate, and early diastolic strain rate by speckle-tracking echocardiography was associated with disease progression during conservative management (−16.3% vs. −19.0%, p = 0.02; −1.04 vs. −1.19 s−1, p = 0.02; and 1.20 vs. 1.60 s−1, p = 0.002, respectively) and with impaired outcome after surgery (−11.5% vs. −15.6%, p = 0.01; −0.88 vs. −1.01 s−1, p = 0.04; and 0.98 vs. 1.33 s−1, p = 0.01, respectively). Conventional parameters of LV function and size (LV ejection fraction and LV end-diastolic volume index) were associated with outcome after surgery (p = 0.04 and p = 0.01, respectively) but not with outcome during conservative management (p = 0.57 and p = 0.39, respectively).
Conclusions Speckle-tracking echocardiography is useful for the early detection of LV systolic and diastolic dysfunction in chronic aortic regurgitation.
This work was supported by a grant to Dr. Olsen from the Danish Heart Foundation (Copenhagen, Denmark). The authors have reported that they have no relationships to disclose.
- Received August 3, 2010.
- Revision received November 9, 2010.
- Accepted November 15, 2010.
- American College of Cardiology Foundation