Document Detail

Subclinical left ventricular dysfunction in asymptomatic severe aortic regurgitation patients with normal ejection fraction: a combined tissue Doppler and velocity vector imaging study.
MedLine Citation:
PMID:  20486957     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Our aim was to evaluate subclinical left ventricular (LV) dysfunction, by two novel echocardiographic techniques, velocity vector imaging (VVI)-derived strain imaging and tissue Doppler imaging (TDI), in patients with asymptomatic, severe aortic regurgitation (AR). METHODS: Forty patients with severe AR with normal ejection fraction and 30 controls were included to the study. All patients underwent a standard echocardiography extended with TDI and VVI analyses. To evaluate the LV longitudinal and circumferential deformation, segmental systolic peak strain and strain rate (SRs) data were acquired from parasternal short axis, apical four-chamber, two-chamber, and long axis views, and additionally LV myocardial velocities, isovolumic myocardial acceleration (IVA), peak systolic velocity (Sa) and peak myocardial velocity during isovolumic contraction (IVV) assessed by TDI. RESULTS: IVA was the only TDI-derived parameter which was significantly impaired in AR patients (P = 0.0001). Both longitudinal and circumferential strain and SRs of the LV were significantly decreased in patients with severe AR (P = 0.0001). Longitudinal and circumferential strain/SRs and TDI-derived LV IVA were inversely correlated with LV end-diastolic diameter (P = 0.0001) and end-systolic diameter (P = 0.0001). TDI-derived IVA was also very well correlated with longitudinal deformation parameters (P = 0.0001). CONCLUSIONS: VVI- derived strain imaging and TDI-derived IVA may be used as adjunctive, reliable, noninvasive parameters for evaluating subclinical ventricular dysfunction in patients with chronic, severe AR. This may help to identify patients for closer follow-up and to determine the need for surgery before developing irreversible, severe heart failure.
Yelda Tayyareci; Ozlem Yildirimturk; Vedat Aytekin; I C Cemsid Demiroglu; Saide Aytekin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  27     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-09-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  260-8     Citation Subset:  IM    
Cardiology Division, Florence Nightingale Hospital, Postal code: 34381, Caglayan, Istanbul, Turkey.
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MeSH Terms
Aortic Valve Insufficiency / physiopathology,  ultrasonography*
Echocardiography, Doppler, Pulsed
Middle Aged
Reference Standards
Ventricular Dysfunction, Left / ultrasonography*

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