PDF(Pubmed)
Abstract：
UNASSIGNED: By combining temporal changes in left ventricular (LV) global longitudinal strain (GLS) with LV volume, LV strain-volume loops can assess cardiac function across the cardiac cycle. This study compared LV strain-volume loops between bicuspid aortic valve (BAV) patients and controls, and investigated the loop\'s prognostic value for clinical events.
UNASSIGNED: From a prospective cohort of congenital heart disease patients, BAV patients were selected and compared with healthy volunteers, who were matched for age and sex at group level. GLS analysis from apical views was used to construct strain-volume loops. Associations with clinical events, i.e. a composite of all-cause mortality, heart failure, arrhythmias, and aortic valve replacement, were assessed by Cox regression. A total of 113 BAV patients were included (median age 32 years, 40% female). BAV patients demonstrated lower Sslope (0.21%/mL, [Q1-Q3: 0.17-0.28] vs. 0.27%/mL [0.24-0.34], P < 0.001) and ESslope (0.19%/mL [0.12-0.25] vs. 0.29%/mL [0.21-0.43], P < 0.001) compared with controls, but also greater uncoupling during early (0.48 ± 1.29 vs. 0.05 ± 1.21, P = 0.04) and late diastole (0.66 ± 1.02 vs. -0.07 ± 1.07, P < 0.001). Median follow-up duration was 9.9 [9.3-10.4] years. Peak aortic jet velocity (HR 1.22, P = 0.03), enlarged left atrium (HR 3.16, P = 0.003), E/e\' ratio (HR 1.17, P = 0.002), GLS (HR 1.16, P = 0.008), and ESslope (HR 0.66, P = 0.04) were associated with the occurrence of clinical events.
UNASSIGNED: Greater uncoupling and lower systolic and diastolic slopes were observed in BAV patients compared with healthy controls, suggesting presence of altered LV cardiomechanics. Moreover, lower ESslope was associated with clinical events, highlighting the strain-volume loop\'s potential as prognostic marker.
UNASSIGNED: From a prospective cohort of congenital heart disease patients, BAV patients were selected and compared with healthy volunteers, who were matched for age and sex at group level. GLS analysis from apical views was used to construct strain-volume loops. Associations with clinical events, i.e. a composite of all-cause mortality, heart failure, arrhythmias, and aortic valve replacement, were assessed by Cox regression. A total of 113 BAV patients were included (median age 32 years, 40% female). BAV patients demonstrated lower Sslope (0.21%/mL, [Q1-Q3: 0.17-0.28] vs. 0.27%/mL [0.24-0.34], P < 0.001) and ESslope (0.19%/mL [0.12-0.25] vs. 0.29%/mL [0.21-0.43], P < 0.001) compared with controls, but also greater uncoupling during early (0.48 ± 1.29 vs. 0.05 ± 1.21, P = 0.04) and late diastole (0.66 ± 1.02 vs. -0.07 ± 1.07, P < 0.001). Median follow-up duration was 9.9 [9.3-10.4] years. Peak aortic jet velocity (HR 1.22, P = 0.03), enlarged left atrium (HR 3.16, P = 0.003), E/e\' ratio (HR 1.17, P = 0.002), GLS (HR 1.16, P = 0.008), and ESslope (HR 0.66, P = 0.04) were associated with the occurrence of clinical events.
UNASSIGNED: Greater uncoupling and lower systolic and diastolic slopes were observed in BAV patients compared with healthy controls, suggesting presence of altered LV cardiomechanics. Moreover, lower ESslope was associated with clinical events, highlighting the strain-volume loop\'s potential as prognostic marker.
摘要：
■通过将左心室（LV）整体纵向应变（GLS）的时间变化与LV体积相结合，LV应变-体积环可以评估整个心动周期的心脏功能。这项研究比较了二尖瓣主动脉瓣（BAV）患者和对照组之间的LV应变-容积环，并研究了循环对临床事件的预后价值。
■从先天性心脏病患者的前瞻性队列中，选择BAV患者，并与健康志愿者进行比较，他们的年龄和性别在群体水平上是匹配的。来自顶端视图的GLS分析用于构建应变-体积环。与临床事件的关联，即全因死亡率的综合，心力衰竭,心律失常,主动脉瓣置换术，通过Cox回归进行评估。共纳入113例BAV患者(中位年龄32岁，40%女性）。BAV患者表现出较低的Sslope（0.21%/mL，[Q1-Q3:0.17-0.28]vs.0.27%/mL[0.24-0.34]，P<0.001）和ESslope（0.19%/mL[0.12-0.25]与0.29%/mL[0.21-0.43]，P<0.001）与对照组相比，但在早期也有更大的解耦(0.48±1.29vs.0.05±1.21，P=0.04）和晚期舒张（0.66±1.02vs.-0.07±1.07,P<0.001)。中位随访时间为9.9[9.3-10.4]年。主动脉射流峰值速度(HR1.22,P=0.03),左心房增大（HR3.16，P=0.003），E/E比值（HR1.17，P=0.002），GLS（HR1.16，P=0.008），和ESslope（HR0.66，P=0.04）与临床事件的发生有关。
■与健康对照相比，在BAV患者中观察到更大的解偶联和更低的收缩和舒张斜率，提示存在改变的LV心脏力学。此外，较低的ESslope与临床事件相关,突出应变-体积环作为预后标志物的潜力。
■从先天性心脏病患者的前瞻性队列中，选择BAV患者，并与健康志愿者进行比较，他们的年龄和性别在群体水平上是匹配的。来自顶端视图的GLS分析用于构建应变-体积环。与临床事件的关联，即全因死亡率的综合，心力衰竭,心律失常,主动脉瓣置换术，通过Cox回归进行评估。共纳入113例BAV患者(中位年龄32岁，40%女性）。BAV患者表现出较低的Sslope（0.21%/mL，[Q1-Q3:0.17-0.28]vs.0.27%/mL[0.24-0.34]，P<0.001）和ESslope（0.19%/mL[0.12-0.25]与0.29%/mL[0.21-0.43]，P<0.001）与对照组相比，但在早期也有更大的解耦(0.48±1.29vs.0.05±1.21，P=0.04）和晚期舒张（0.66±1.02vs.-0.07±1.07,P<0.001)。中位随访时间为9.9[9.3-10.4]年。主动脉射流峰值速度(HR1.22,P=0.03),左心房增大（HR3.16，P=0.003），E/E比值（HR1.17，P=0.002），GLS（HR1.16，P=0.008），和ESslope（HR0.66，P=0.04）与临床事件的发生有关。
■与健康对照相比，在BAV患者中观察到更大的解偶联和更低的收缩和舒张斜率，提示存在改变的LV心脏力学。此外，较低的ESslope与临床事件相关,突出应变-体积环作为预后标志物的潜力。
