Mark Coyle, Gerard King, Kathleen Bennett, Andrew Maree, Mark Hensey, Stephen O'Connor, Caroline Daly, Gregory Murphy, Ross T Murphy
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Individual participants were assessed for differences in GLS, PALS and radial strain in addition to changes in left ventricular ejection fraction (LVEF) (%).</p><p><strong>Results: </strong>Our results revealed a significant improvement in GLS (mean change pre-post of 2.14% [95% CI 1.08, 3.20] p = 0.0003) with no significant change in LVEF (0.96% [95% CI - 2.30, 4.22], p = 0.55). There was a statistically significant improvement in radial strain pre and post TAVI (mean 9.68% [95% CI 3.10, 16.25] p = 0.0058). There was positive trend towards improvements in PALS pre and post TAVI (mean change of 2.30% [95% CI - 0.19, 4.80] p = 0.068).</p><p><strong>Conclusion: </strong>In patients undergoing TAVI, measuring GLS and radial strain provided statistically significant information regarding subclinical improvements in LV function, which may have prognostic implications. 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引用次数: 0
摘要
背景:变形成像是一种测量心肌功能的方法，包括总纵向应变(GLS)、心房纵向应变峰(PALS)和径向应变。本研究旨在通过比较经导管主动脉瓣植入术(TAVI)前后的GLS、PALS和径向应变，评估经导管主动脉瓣植入术患者左心室功能的亚临床改善。方法:我们对25例接受TAVI的患者进行了一项单点前瞻性观察研究，比较了TAVI基线和术后超声心动图。评估个体参与者GLS、PALS和径向应变的差异以及左心室射血分数(LVEF)(%)的变化。结果:我们的结果显示GLS有显著改善(术后平均变化2.14% [95% CI - 1.08, 3.20] p = 0.0003)， LVEF无显著变化(0.96% [95% CI - 2.30, 4.22]， p = 0.55)。TAVI前后桡骨应变的改善有统计学意义(平均9.68% [95% CI 3.10, 16.25] p = 0.0058)。TAVI前后PALS均有改善的趋势(平均变化2.30% [95% CI - 0.19, 4.80] p = 0.068)。结论:在接受TAVI的患者中，测量GLS和径向应变提供了关于左室功能亚临床改善的具有统计学意义的信息，这可能具有预后意义。除了标准超声心动图测量外，变形成像的结合可能对指导TAVI患者未来的治疗和评估反应具有重要作用。
The use of deformation imaging in the assessment of patients pre and post transcatheter aortic valve implantation.
Background: Deformation imaging represents a method of measuring myocardial function, including global longitudinal strain (GLS), peak atrial longitudinal strain (PALS) and radial strain. This study aimed to assess subclinical improvements in left ventricular function in patients undergoing transcatheter aortic valve implantation (TAVI) by comparing GLS, PALS and radial strain pre and post procedure.
Methods: We conducted a single site prospective observational study of 25 patients undergoing TAVI, comparing baseline and post-TAVI echocardiograms. Individual participants were assessed for differences in GLS, PALS and radial strain in addition to changes in left ventricular ejection fraction (LVEF) (%).
Results: Our results revealed a significant improvement in GLS (mean change pre-post of 2.14% [95% CI 1.08, 3.20] p = 0.0003) with no significant change in LVEF (0.96% [95% CI - 2.30, 4.22], p = 0.55). There was a statistically significant improvement in radial strain pre and post TAVI (mean 9.68% [95% CI 3.10, 16.25] p = 0.0058). There was positive trend towards improvements in PALS pre and post TAVI (mean change of 2.30% [95% CI - 0.19, 4.80] p = 0.068).
Conclusion: In patients undergoing TAVI, measuring GLS and radial strain provided statistically significant information regarding subclinical improvements in LV function, which may have prognostic implications. The incorporation of deformation imaging in addition to standard echocardiographic measurements may have an important role in guiding future management in patients undergoing TAVI and assessing response.
期刊介绍：
Echo Research and Practice aims to be the premier international journal for physicians, sonographers, nurses and other allied health professionals practising echocardiography and other cardiac imaging modalities. This open-access journal publishes quality clinical and basic research, reviews, videos, education materials and selected high-interest case reports and videos across all echocardiography modalities and disciplines, including paediatrics, anaesthetics, general practice, acute medicine and intensive care. Multi-modality studies primarily featuring the use of cardiac ultrasound in clinical practice, in association with Cardiac Computed Tomography, Cardiovascular Magnetic Resonance or Nuclear Cardiology are of interest. Topics include, but are not limited to: 2D echocardiography 3D echocardiography Comparative imaging techniques – CCT, CMR and Nuclear Cardiology Congenital heart disease, including foetal echocardiography Contrast echocardiography Critical care echocardiography Deformation imaging Doppler echocardiography Interventional echocardiography Intracardiac echocardiography Intraoperative echocardiography Prosthetic valves Stress echocardiography Technical innovations Transoesophageal echocardiography Valve disease.
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