open access

Vol 25, No 2 (2018)
Original articles — Clinical cardiology
Published online: 2017-10-18
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Myocardial strain characteristics and outcomes after transcatheter aortic valve replacement

Dominik Buckert, Raid Tibi, Maciej Cieslik, Michael Radermacher, Yang-Yang Qu, Volker Rasche, Peter Bernhardt, Vinzenz Hombach, Wolfgang Rottbauer, Jochen Wöhrle
DOI: 10.5603/CJ.a2017.0121
·
Pubmed: 29064540
·
Cardiol J 2018;25(2):203-212.

open access

Vol 25, No 2 (2018)
Original articles — Clinical cardiology
Published online: 2017-10-18

Abstract

 Background: Objective of this study was to make an assessment of standard functional and defor­mation parameters (strain) in patients after transcatheter aortic valve replacement (TAVR) by cardiac magnetic resonance imaging (CMR) and the evaluation of their prognostic impact.

Methods: Patients undergoing TAVR received CMR on a 1.5 T whole-body scanner at 3 months after the procedure. Deformation parameters (strain, strain rate, velocity, displacement) were assessed in lon­gitudinal, circumferential and radial orientation using a feature tracking approach. Primary outcome measure was defined according to Valve Academic Research Consortium-2 (VARC-2) criteria.

Results: Eighty-three patients formed the study population. Deformation parameters were significantly reduced in all three orientations for strain (longitudinal: –12.1 ± 5.4% vs. –15.9 ± 1.96%, p < 0.0001; radial: 34.4 ± 15.3% vs. 47.2 ± 11.4%, p < 0.0001; circumferential: –16.8 ± 4.3% vs. –21.1 ± 2.5%, p < 0.0001) and strain rate (longitudinal: –0.79 ± 0.33%/s vs. –0.91 ± 0.23%/s, p = 0.043; radial: 2.5 ± 1.2%/s vs. 2.9 ± 0.9%, p = 0.067; circumferential: –1.1 ± 0.6%/s vs. –1.3 ± 0.3%/s, p = 0.006) in comparison to a healthy control population. Median follow-up was 614 days. During this period, 13 endpoints occurred (cumulative event rate of 10.7%). Patients with event by trend exhibited poorer strain and strain rate in longitudinal and radial orientation without reaching statistical significance (longitudinal strain: –11.2 ± 5.4% vs. –12.3 ± 5.4%, p = 0.52; longitudinal strain rate: –0.73 ± ± 0.23%/s vs. 0.80 ± 0.35%/s, p = 0.53; radial strain: 29.5 ± 19.6% vs. 35.2 ± 14.5%, p = 0.24; radial strain rate: 2.2 ± 1.6%/s vs. 2.6 ± 1.2%/s, p = 0.31).

Conclusions: Assessment of left ventricular deformation parameters by CMR revealed functional abnormalities in comparison to healthy controls. Prognostic significance remains to be further investi­gated.  

Abstract

 Background: Objective of this study was to make an assessment of standard functional and defor­mation parameters (strain) in patients after transcatheter aortic valve replacement (TAVR) by cardiac magnetic resonance imaging (CMR) and the evaluation of their prognostic impact.

Methods: Patients undergoing TAVR received CMR on a 1.5 T whole-body scanner at 3 months after the procedure. Deformation parameters (strain, strain rate, velocity, displacement) were assessed in lon­gitudinal, circumferential and radial orientation using a feature tracking approach. Primary outcome measure was defined according to Valve Academic Research Consortium-2 (VARC-2) criteria.

Results: Eighty-three patients formed the study population. Deformation parameters were significantly reduced in all three orientations for strain (longitudinal: –12.1 ± 5.4% vs. –15.9 ± 1.96%, p < 0.0001; radial: 34.4 ± 15.3% vs. 47.2 ± 11.4%, p < 0.0001; circumferential: –16.8 ± 4.3% vs. –21.1 ± 2.5%, p < 0.0001) and strain rate (longitudinal: –0.79 ± 0.33%/s vs. –0.91 ± 0.23%/s, p = 0.043; radial: 2.5 ± 1.2%/s vs. 2.9 ± 0.9%, p = 0.067; circumferential: –1.1 ± 0.6%/s vs. –1.3 ± 0.3%/s, p = 0.006) in comparison to a healthy control population. Median follow-up was 614 days. During this period, 13 endpoints occurred (cumulative event rate of 10.7%). Patients with event by trend exhibited poorer strain and strain rate in longitudinal and radial orientation without reaching statistical significance (longitudinal strain: –11.2 ± 5.4% vs. –12.3 ± 5.4%, p = 0.52; longitudinal strain rate: –0.73 ± ± 0.23%/s vs. 0.80 ± 0.35%/s, p = 0.53; radial strain: 29.5 ± 19.6% vs. 35.2 ± 14.5%, p = 0.24; radial strain rate: 2.2 ± 1.6%/s vs. 2.6 ± 1.2%/s, p = 0.31).

Conclusions: Assessment of left ventricular deformation parameters by CMR revealed functional abnormalities in comparison to healthy controls. Prognostic significance remains to be further investi­gated.  

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Keywords

cardiac magnetic resonance imaging, strain imaging, cardiac mechanics, severe aortic stenosis, transcatheter aortic valve replacement, outcomes and prognosis

About this article
Title

Myocardial strain characteristics and outcomes after transcatheter aortic valve replacement

Journal

Cardiology Journal

Issue

Vol 25, No 2 (2018)

Pages

203-212

Published online

2017-10-18

DOI

10.5603/CJ.a2017.0121

Pubmed

29064540

Bibliographic record

Cardiol J 2018;25(2):203-212.

Keywords

cardiac magnetic resonance imaging
strain imaging
cardiac mechanics
severe aortic stenosis
transcatheter aortic valve replacement
outcomes and prognosis

Authors

Dominik Buckert
Raid Tibi
Maciej Cieslik
Michael Radermacher
Yang-Yang Qu
Volker Rasche
Peter Bernhardt
Vinzenz Hombach
Wolfgang Rottbauer
Jochen Wöhrle

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