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Open Access 01-01-2018 | Original Paper

Longitudinal strain assessed by cardiac magnetic resonance correlates to hemodynamic findings in patients with severe aortic stenosis and predicts positive remodeling after transcatheter aortic valve replacement

Authors: Dominik Buckert, Maciej Cieslik, Raid Tibi, Michael Radermacher, Volker Rasche, Peter Bernhardt, Vinzenz Hombach, Wolfgang Rottbauer, Jochen Wöhrle

Published in: Clinical Research in Cardiology | Issue 1/2018

Abstract

Aims

To assess left-ventricular strain parameters before and after transcatheter aortic valve replacement (TAVR) by feature tracking cardiac magnetic resonance imaging (FT CMR) and to correlate the findings to hemodynamic state and left-ventricular remodeling.

Methods and results

Patients with symptomatic AS underwent FT CMR before and after TAVR. Patients were carefully evaluated by a comprehensive work-up including CMR, echocardiography and left and right heart catheterization. Thirty patients formed the study population. High-flow/high-gradient (HF/HG) aortic stenosis was diagnosed in 11 patients (36.7%), 6 patients (20.0%) exhibited low-flow/low-gradient AS (LF/LG) and 13 patients (43.3%) were classified to have so-called paradoxical low-flow/low-gradient (PLF/LG) AS. The HF/HG patients had a significantly reduced longitudinal strain which recovered after TAVR (−12.67 ± 4.60 to −15.46 ± 5.61%, p = 0.048). In the LF/LG group, an even more pronounced reduction of longitudinal strain and also an impairment of longitudinal velocity could be observed. Both parameters improved after therapy (strain: −5.06 ± 4.25 to −8.02 ± 3.28%, p = 0.045; velocity: 25.33 ± 9.63 to 37.13 ± 11.64 mm/s, p = 0.042). Patients with PLF/LG showed preserved longitudinal strain but a reduction of longitudinal velocity similar to the LF/LG group. These patients did not show a significant improvement of strain parameters after TAVR. Longitudinal velocity exhibited the highest predictive power for the identification of a low-flow state (sensitivity 75%, specificity 80%).

Conclusion

Improvement of longitudinal strain parameters after TAVR is dependent on the initial hemodynamically defined AS subgroup.

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Title: Longitudinal strain assessed by cardiac magnetic resonance correlates to hemodynamic findings in patients with severe aortic stenosis and predicts positive remodeling after transcatheter aortic valve replacement
Authors: Dominik Buckert
Maciej Cieslik
Raid Tibi
Michael Radermacher
Volker Rasche
Peter Bernhardt
Vinzenz Hombach
Wolfgang Rottbauer
Jochen Wöhrle
Publication date: 01-01-2018
Publisher: Springer Berlin Heidelberg
Published in: Clinical Research in Cardiology / Issue 1/2018
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-017-1153-7

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Springer Medicine

Longitudinal strain assessed by cardiac magnetic resonance correlates to hemodynamic findings in patients with severe aortic stenosis and predicts positive remodeling after transcatheter aortic valve replacement

Abstract

Aims

Methods and results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aims

Methods and results

Conclusion

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