LV Mechanics in Mitral and Aortic Valve Diseases

Abstract The assessment of myocardial function in the context of valvular heart disease remains highly challenging. The myocardium deforms simultaneously in 3 dimensions, and global left ventricular (LV) function parameters such as volume and ejection fraction may remain compensated despite the chan...

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Published inJACC. Cardiovascular imaging Vol. 7; no. 11; pp. 1151 - 1166
Main Authors Galli, Elena, MD, PhD, Lancellotti, Patrizio, MD, PhD, Sengupta, Partho P., MD, DM, Donal, Erwan, MD, PhD
Format Journal Article
LanguageEnglish
Published 01.11.2014
Subjects
Cardiovascular
aortic valve replacement
RV
left ventricle
STE
left ventricular ejection fraction
LVEF
LV
tissue Doppler imaging
GLS
aortic stenosis
VHD
ESD
low gradient
TDI
valvular heart disease
LVESD
speckle tracking echocardiography
left ventricular function
right ventricular
MR
mitral regurgitation
MS
CMR
low flow
global longitudinal strain
left ventricular end-systolic diameter
AS
deformation imaging
valvular heart disease
mitral stenosis
LF
LG
AVR
cardiac magnetic resonance
end-systolic diameter
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Summary:Abstract The assessment of myocardial function in the context of valvular heart disease remains highly challenging. The myocardium deforms simultaneously in 3 dimensions, and global left ventricular (LV) function parameters such as volume and ejection fraction may remain compensated despite the changes in myocardial deformation properties. Current guidelines recommend valve replacement/repair in the presence of symptoms or reduced LV ejection fraction, but the resolution of symptoms or recovery of LV function post-surgery may not be reliably predicted. A wealth of evidence currently suggests that LV dysfunction is frequently subclinical despite normal ejection fraction. It may precede the onset of symptoms and portend a poor outcome due to progressive myocardial remodeling and dysfunction during the post-operative period. The advent of novel tissue-tracking echocardiography techniques has unleashed new opportunities for the clinical identification of early abnormalities in LV function. This review gathers and summarizes current evidence regarding the use of these techniques to assess myocardial deformation in patients with valvular heart disease.
ISSN:1936-878X
DOI:10.1016/j.jcmg.2014.07.015