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Shifting from Left Ventricular Ejection Fraction to Strain Imaging in Aortic Stenosis
Adverse ventricular remodeling is an inflexion point of disease progression in aortic stenosis (AS) and a major determinant of prognosis. Intervention before irreversible myocardial damage is of paramount importance to sustain favorable post-operative outcomes. Current guidelines recommend a left ve...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10217605/ https://www.ncbi.nlm.nih.gov/pubmed/37238238 http://dx.doi.org/10.3390/diagnostics13101756 |
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author | Anastasiou, Vasileios Daios, Stylianos Bazmpani, Maria-Anna Moysidis, Dimitrios V. Zegkos, Thomas Karamitsos, Theodoros Ziakas, Antonios Kamperidis, Vasileios |
author_facet | Anastasiou, Vasileios Daios, Stylianos Bazmpani, Maria-Anna Moysidis, Dimitrios V. Zegkos, Thomas Karamitsos, Theodoros Ziakas, Antonios Kamperidis, Vasileios |
author_sort | Anastasiou, Vasileios |
collection | PubMed |
description | Adverse ventricular remodeling is an inflexion point of disease progression in aortic stenosis (AS) and a major determinant of prognosis. Intervention before irreversible myocardial damage is of paramount importance to sustain favorable post-operative outcomes. Current guidelines recommend a left ventricular ejection fraction (LVEF)-based strategy to determine the threshold for intervention in AS. However, LVEF has several pitfalls: it denotes the left ventricular cavity volumetric changes and it is not suited to detecting subtle signs of myocardial damage. Strain has emerged as a contemporary imaging biomarker that describes intramyocardial contractile force, providing information on subclinical myocardial dysfunction due to fibrosis. A large body of evidence advocates its use to determine the switch from adaptive to maladaptive myocardial changes in AS, and to refine thresholds for intervention. Although mainly studied in echocardiography, studies exploring the role of strain in multi-detector row computed tomography and cardiac magnetic resonance are emerging. This review, therefore, summarizes contemporary evidence on the role of LVEF and strain imaging in AS prognosis, aiming to move from an LVEF-based to a strain-based approach for risk stratification and therapeutic decision-making in AS. |
format | Online Article Text |
id | pubmed-10217605 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-102176052023-05-27 Shifting from Left Ventricular Ejection Fraction to Strain Imaging in Aortic Stenosis Anastasiou, Vasileios Daios, Stylianos Bazmpani, Maria-Anna Moysidis, Dimitrios V. Zegkos, Thomas Karamitsos, Theodoros Ziakas, Antonios Kamperidis, Vasileios Diagnostics (Basel) Review Adverse ventricular remodeling is an inflexion point of disease progression in aortic stenosis (AS) and a major determinant of prognosis. Intervention before irreversible myocardial damage is of paramount importance to sustain favorable post-operative outcomes. Current guidelines recommend a left ventricular ejection fraction (LVEF)-based strategy to determine the threshold for intervention in AS. However, LVEF has several pitfalls: it denotes the left ventricular cavity volumetric changes and it is not suited to detecting subtle signs of myocardial damage. Strain has emerged as a contemporary imaging biomarker that describes intramyocardial contractile force, providing information on subclinical myocardial dysfunction due to fibrosis. A large body of evidence advocates its use to determine the switch from adaptive to maladaptive myocardial changes in AS, and to refine thresholds for intervention. Although mainly studied in echocardiography, studies exploring the role of strain in multi-detector row computed tomography and cardiac magnetic resonance are emerging. This review, therefore, summarizes contemporary evidence on the role of LVEF and strain imaging in AS prognosis, aiming to move from an LVEF-based to a strain-based approach for risk stratification and therapeutic decision-making in AS. MDPI 2023-05-16 /pmc/articles/PMC10217605/ /pubmed/37238238 http://dx.doi.org/10.3390/diagnostics13101756 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Anastasiou, Vasileios Daios, Stylianos Bazmpani, Maria-Anna Moysidis, Dimitrios V. Zegkos, Thomas Karamitsos, Theodoros Ziakas, Antonios Kamperidis, Vasileios Shifting from Left Ventricular Ejection Fraction to Strain Imaging in Aortic Stenosis |
title | Shifting from Left Ventricular Ejection Fraction to Strain Imaging in Aortic Stenosis |
title_full | Shifting from Left Ventricular Ejection Fraction to Strain Imaging in Aortic Stenosis |
title_fullStr | Shifting from Left Ventricular Ejection Fraction to Strain Imaging in Aortic Stenosis |
title_full_unstemmed | Shifting from Left Ventricular Ejection Fraction to Strain Imaging in Aortic Stenosis |
title_short | Shifting from Left Ventricular Ejection Fraction to Strain Imaging in Aortic Stenosis |
title_sort | shifting from left ventricular ejection fraction to strain imaging in aortic stenosis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10217605/ https://www.ncbi.nlm.nih.gov/pubmed/37238238 http://dx.doi.org/10.3390/diagnostics13101756 |
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