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The Prognostic Value of Myocardial Deformation in Patients with Congenital Aortic Stenosis

Roderick W. J. van Grootel, Allard T. van den Hoven, Dan Bowen, Tijmen Ris, Jolien W. Roos-Hesselink, Annemien E. van den Bosch*

Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands

* Corresponding Author: Annemien E. van den Bosch. Email: email

Congenital Heart Disease 2021, 16(3), 221-232. https://doi.org/10.32604/CHD.2021.013793

Abstract

Aims: To assess the prognostic value of left ventricular (LV) global longitudinal strain (GLS) and global longitudinal early diastolic strain rate (GLSre) with regard to cardiovascular events, as congenital aortic stenosis (AoS) is associated with significant mortality and morbidity but predictors for clinical outcome are scarce. Strain analysis provides a robust and reproducible method for early detection of LV dysfunction, which might be of prognostic value. Methods: This prospective study, included clinically stable patients with congenital AoS between 2011–2013. LV GLS and GLSre was performed in the apical 4, 3 and 2-chamber views using Tomtec software. The endpoint was a composite of death, heart failure, hospitalization, arrhythmia, thrombo-embolic events and re-intervention. Results: In total 138 patients were included (33[26–43] years, 86(62%) male), NYHA class I: 134(97%). Mean LV GLS was –15.3 ± 3.2%, GLSre 0.66 ± 0.18 s–1. Both correlated with NT-proBNP, LV volumes and ejection fraction (strongest LV GLS with LV EF: r –0.539, p < 0.001, strongest LV GLSre with age: r –0.376, p < 0.001). During median follow-up of 5.9[5.5–6.2] years, the endpoint occurred in 53(38%) patients: 4 patients died, 9 developed heart failure, 22 arrhythmias, 8 thrombo-embolic events and 35 re-interventions. Both LV GLS (standardized HR (sHR 0.62(95%CI 0.47–0.81) and GLSre (sHR 0.62(95%CI 0.47–0.83) were associated with the endpoint. Additional multivariable analysis showed that both GLS and GLSre were associated independent of left atrial volume, NT-proBNP and prior re-interventions. Conclusion: Left ventricular GLS and GLSre are reduced in adult patients with congenital AoS. Both markers are associated with adverse cardiac events and have clear clinical relevance.

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APA Style
Grootel, R.W.J.V., Hoven, A.T.V.D., Bowen, D., Ris, T., Roos-Hesselink, J.W. et al. (2021). The prognostic value of myocardial deformation in patients with congenital aortic stenosis. Congenital Heart Disease, 16(3), 221-232. https://doi.org/10.32604/CHD.2021.013793
Vancouver Style
Grootel RWJV, Hoven ATVD, Bowen D, Ris T, Roos-Hesselink JW, Bosch AEVD. The prognostic value of myocardial deformation in patients with congenital aortic stenosis. Congeni Heart Dis. 2021;16(3):221-232 https://doi.org/10.32604/CHD.2021.013793
IEEE Style
R.W.J.V. Grootel, A.T.V.D. Hoven, D. Bowen, T. Ris, J.W. Roos-Hesselink, and A.E.V.D. Bosch "The Prognostic Value of Myocardial Deformation in Patients with Congenital Aortic Stenosis," Congeni. Heart Dis., vol. 16, no. 3, pp. 221-232. 2021. https://doi.org/10.32604/CHD.2021.013793



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