Left Ventricular Strain as Predictor of Chronic Aortic Regurgitation
2
조회
0
다운로드
1
인용
0
참고문헌
초록
Background: It is not well known about the implication of left ventricular (LV) strain as a predictor for mortality in patientswith chronic aortic regurgitation (AR). The purpose of this study was to investigate whether global longitudinal strain measuredby two-dimensional speckle-tracking echocardiography could predict long-term outcome in patients with chronic AR. Methods: This is a single center non-randomized retrospective observational study. The patients with chronic AR from January2002 to December 2012 were retrospectively enrolled. Following patients were excluded; combined other significant valvulardisease, previous heart surgery, aortic disease, congenital heart disease, acute AR and young age under 18 years old. Finally, 60patients were analyzed and the LV global strain rate was measured on apical four chamber image (GS-4CH). Results: During 64 months follow-up duration, 16 patients (26.7%) were deceased and 38 patients (63.3%) underwent aorticvalve replacement (AVR). Deceased group was older (69 years old vs. 51 years old, p < 0.001) and had lower longitudinal strain(-12.05 ± 3.72% vs. -15.66 ± 4.35%, p = 0.005). Kaplan-Meier survival curve stratified by GS-4CH showed a trend of differentevent rate (log rank p = 0.001). On multivariate analysis by cox proportional hazard model adjusting for age, sex, body surfacearea, history of atrial fibrillation, blood urea nitrogen, LV dilatation, LV ejection fraction and AVR, decreased GS-4CH provedto be an independent predictor of mortality in patients with chronic AR (hazard ratio 1.313, 95% confidence interval 1.010–1.706, p = 0.042). Conclusion: GS-4CH may be a useful predictor of mortality in patient with chronic AR.
Abstract
Background: It is not well known about the implication of left ventricular (LV) strain as a predictor for mortality in patientswith chronic aortic regurgitation (AR). The purpose of this study was to investigate whether global longitudinal strain measuredby two-dimensional speckle-tracking echocardiography could predict long-term outcome in patients with chronic AR. Methods: This is a single center non-randomized retrospective observational study. The patients with chronic AR from January2002 to December 2012 were retrospectively enrolled. Following patients were excluded; combined other significant valvulardisease, previous heart surgery, aortic disease, congenital heart disease, acute AR and young age under 18 years old. Finally, 60patients were analyzed and the LV global strain rate was measured on apical four chamber image (GS-4CH). Results: During 64 months follow-up duration, 16 patients (26.7%) were deceased and 38 patients (63.3%) underwent aorticvalve replacement (AVR). Deceased group was older (69 years old vs. 51 years old, p < 0.001) and had lower longitudinal strain(-12.05 ± 3.72% vs. -15.66 ± 4.35%, p = 0.005). Kaplan-Meier survival curve stratified by GS-4CH showed a trend of differentevent rate (log rank p = 0.001). On multivariate analysis by cox proportional hazard model adjusting for age, sex, body surfacearea, history of atrial fibrillation, blood urea nitrogen, LV dilatation, LV ejection fraction and AVR, decreased GS-4CH provedto be an independent predictor of mortality in patients with chronic AR (hazard ratio 1.313, 95% confidence interval 1.010–1.706, p = 0.042). Conclusion: GS-4CH may be a useful predictor of mortality in patient with chronic AR.
참고문헌 (14)
- Iida N, "Transmural compensation of myocardial deformation to preserve left ventricular ejection performance in chronic aortic regurgitation", J Am Soc Echocardiogr, 25, pp.620~628 (2012)
- Bonow RO, "American College of Cardiology", American Heart Association Task Force on Practice Guidelines. 2008 focused update incorporated into the ACC, American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons, pp.J Am Coll Cardiol, 2008[DOI]
- Ekery DL, "Aortic regurgitation : quantitative methods by echocardiography", Echocardiography, 17, pp.293~302 (2000)
- The Korean Society of Echocardiography, "The Text Book of Clinical Echocardiography", pp.329~333 (2013), Daehan Medical Books
- Detaint D, "Quantitative echocardiographic determinants of clinical outcome in asymptomatic patients with aortic regurgitation : a prospective study", JACC Cardiovasc Imaging, 1, pp.1~11 (2008)
- Bonow RO, "ACC", AHA 2006guidelines for the management of patients with valvular heart disease : a report of the American College of Cardiology, Circulation, pp.2006, 114[DOI]
- Tornos MP, "Clinical outcome of severe asymptomatic chronic aortic regurgitation : a long-term prospective follow-up study", Am Heart J, 130, pp.333~339 (1995)
- Onishi T, "Preoperative systolic strain rate predicts postoperative left ventricular dysfunction in patients with chronic aortic regurgitation", Circ Cardiovasc Imaging, 3, pp.134~141 (2010)
- Chaliki HP, "Outcomes after aortic valve replacement in patients with severe aortic regurgitation and markedly reduced left ventricular function", Circulation, 106, pp.2687~2693 (2002)
- Edvardsen T, "Quantitative assessment of intrinsic regional myocardial deformation by Doppler strain rate echocardiography in humans : validation against threedimensional tagged magnetic resonance imaging", Circulation, 106, pp.50~56 (2002)
- Yu CM, "Tissue Doppler imaging a new prognosticator for cardiovascular diseases", J Am Coll Cardiol, 49, pp.1903~1914 (2007)
- Marciniak A, "Myocardial deformation abnormalities in patients with aortic regurgitation : a strain rate imaging study", Eur J Echocardiogr, 10, pp.112~119 (2009)
- Di Salvo G, "Usefulness of bidimensional strain imaging for predicting outcome in asymptomatic patients aged ≤ 16years with isolated moderate to severe aortic regurgitation", Am J Cardiol, 110, pp.1051~1055 (2012)
- Olsen NT, "Speckle-tracking echocardiography for predicting outcome in chronic aortic regurgitation during conservative management and after surgery", JACC Cardiovasc Imaging, 4, pp.223~230 (2011)