Persistent reduction in left ventricular strain using two-dimensional speckle-tracking echocardiography after balloon valvuloplasty in children with congenital valvular aortic stenosis

Karen A Marcus; Chris L de Korte; Ton Feuth; Johan M Thijssen; Anton M van Oort; Ronald B Tanke; Livia Kapusta

doi:10.1016/j.echo.2012.01.009

Persistent reduction in left ventricular strain using two-dimensional speckle-tracking echocardiography after balloon valvuloplasty in children with congenital valvular aortic stenosis

Karen A Marcus, Chris L de Korte, Ton Feuth, Johan M Thijssen, Anton M van Oort, Ronald B Tanke, Livia Kapusta

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: The aim of this study was to investige serial changes of myocardial deformation using two-dimensional speckle-tracking echocardiographic (2DSTE) imaging in children undergoing balloon valvuloplasty for congenital valvular aortic stenosis (VAS).

METHODS: Thirty-seven children with isolated congenital VAS were enrolled in this study prospectively. Patients underwent echocardiographic evaluation at three instances: before balloon valvuloplasty, 6 months after intervention, and 3 years after intervention. Longitudinal, circumferential, and radial peak systolic strain values were determined, as well as systolic strain rate and the time to peak global systolic strain. Linear mixed statistical models were used to assess changes in 2DSTE parameters after balloon intervention. Using one-way analysis of variance, 2DSTE results at 3-year follow-up were compared with 2DSTE measurements in 74 healthy age-matched children and 76 children with uncorrected VAS whose severity of stenosis corresponded to residual stenosis of study subjects at 3-year follow-up.

RESULTS: Global peak strain and strain rate measurements in all three directions were decreased before intervention compared with healthy children. Global peak strain and strain rate measurements increased significantly (P < .001) several months after balloon valvuloplasty and continued to increase at 3-year follow-up. However, at 3-year follow-up, global peak strain and strain rate in the longitudinal and circumferential directions were significantly lower (P < .001) compared with both control groups. Measurements of time to peak global systolic strain were significantly shorter at early follow-up compared with measurements before intervention (P < .05).

CONCLUSIONS: Shortly after balloon valvuloplasty for severe congenital VAS, there is an improvement in systolic myocardial deformation. However, 2DSTE parameters do not return to normal at 3-year follow-up. These abnormalities in systolic deformation cannot be fully attributed to residual stenosis or aortic regurgitation.

Original language	English
Pages (from-to)	473-85
Number of pages	13
Journal	Journal of the American Society of Echocardiography
Volume	25
Issue number	5
DOIs	https://doi.org/10.1016/j.echo.2012.01.009
Publication status	Published - May 2012
Externally published	Yes

Keywords

Adolescent
Age Factors
Analysis of Variance
Anthropometry
Aortic Valve Stenosis/congenital
Case-Control Studies
Catheterization/methods
Child, Preschool
Echocardiography, Doppler/methods
Echocardiography, Doppler, Color/methods
Female
Follow-Up Studies
Heart Defects, Congenital/diagnostic imaging
Humans
Infant, Newborn
Linear Models
Male
Multivariate Analysis
Reference Values
Retrospective Studies
Risk Assessment
Sex Factors
Treatment Outcome
Ventricular Function/physiology
Ventricular Remodeling/physiology

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10.1016/j.echo.2012.01.009

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Marcus, K. A., de Korte, C. L., Feuth, T., Thijssen, J. M., van Oort, A. M., Tanke, R. B., & Kapusta, L. (2012). Persistent reduction in left ventricular strain using two-dimensional speckle-tracking echocardiography after balloon valvuloplasty in children with congenital valvular aortic stenosis. Journal of the American Society of Echocardiography, 25(5), 473-85. https://doi.org/10.1016/j.echo.2012.01.009

@article{f5fa55956c1a4d15a56ec7694b4a8660,

title = "Persistent reduction in left ventricular strain using two-dimensional speckle-tracking echocardiography after balloon valvuloplasty in children with congenital valvular aortic stenosis",

abstract = "BACKGROUND: The aim of this study was to investige serial changes of myocardial deformation using two-dimensional speckle-tracking echocardiographic (2DSTE) imaging in children undergoing balloon valvuloplasty for congenital valvular aortic stenosis (VAS).METHODS: Thirty-seven children with isolated congenital VAS were enrolled in this study prospectively. Patients underwent echocardiographic evaluation at three instances: before balloon valvuloplasty, 6 months after intervention, and 3 years after intervention. Longitudinal, circumferential, and radial peak systolic strain values were determined, as well as systolic strain rate and the time to peak global systolic strain. Linear mixed statistical models were used to assess changes in 2DSTE parameters after balloon intervention. Using one-way analysis of variance, 2DSTE results at 3-year follow-up were compared with 2DSTE measurements in 74 healthy age-matched children and 76 children with uncorrected VAS whose severity of stenosis corresponded to residual stenosis of study subjects at 3-year follow-up.RESULTS: Global peak strain and strain rate measurements in all three directions were decreased before intervention compared with healthy children. Global peak strain and strain rate measurements increased significantly (P < .001) several months after balloon valvuloplasty and continued to increase at 3-year follow-up. However, at 3-year follow-up, global peak strain and strain rate in the longitudinal and circumferential directions were significantly lower (P < .001) compared with both control groups. Measurements of time to peak global systolic strain were significantly shorter at early follow-up compared with measurements before intervention (P < .05).CONCLUSIONS: Shortly after balloon valvuloplasty for severe congenital VAS, there is an improvement in systolic myocardial deformation. However, 2DSTE parameters do not return to normal at 3-year follow-up. These abnormalities in systolic deformation cannot be fully attributed to residual stenosis or aortic regurgitation.",

keywords = "Adolescent, Age Factors, Analysis of Variance, Anthropometry, Aortic Valve Stenosis/congenital, Case-Control Studies, Catheterization/methods, Child, Preschool, Echocardiography, Doppler/methods, Echocardiography, Doppler, Color/methods, Female, Follow-Up Studies, Heart Defects, Congenital/diagnostic imaging, Humans, Infant, Newborn, Linear Models, Male, Multivariate Analysis, Reference Values, Retrospective Studies, Risk Assessment, Sex Factors, Treatment Outcome, Ventricular Function/physiology, Ventricular Remodeling/physiology",

author = "Marcus, {Karen A} and {de Korte}, {Chris L} and Ton Feuth and Thijssen, {Johan M} and {van Oort}, {Anton M} and Tanke, {Ronald B} and Livia Kapusta",

year = "2012",

month = may,

doi = "10.1016/j.echo.2012.01.009",

language = "English",

volume = "25",

pages = "473--85",

journal = "Journal of the American Society of Echocardiography",

issn = "0894-7317",

publisher = "Mosby Inc.",

number = "5",

}

Marcus, KA, de Korte, CL, Feuth, T, Thijssen, JM, van Oort, AM, Tanke, RB & Kapusta, L 2012, 'Persistent reduction in left ventricular strain using two-dimensional speckle-tracking echocardiography after balloon valvuloplasty in children with congenital valvular aortic stenosis', Journal of the American Society of Echocardiography, vol. 25, no. 5, pp. 473-85. https://doi.org/10.1016/j.echo.2012.01.009

Persistent reduction in left ventricular strain using two-dimensional speckle-tracking echocardiography after balloon valvuloplasty in children with congenital valvular aortic stenosis. / Marcus, Karen A; de Korte, Chris L; Feuth, Ton et al.
In: Journal of the American Society of Echocardiography, Vol. 25, No. 5, 05.2012, p. 473-85.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Persistent reduction in left ventricular strain using two-dimensional speckle-tracking echocardiography after balloon valvuloplasty in children with congenital valvular aortic stenosis

AU - Marcus, Karen A

AU - de Korte, Chris L

AU - Feuth, Ton

AU - Thijssen, Johan M

AU - van Oort, Anton M

AU - Tanke, Ronald B

AU - Kapusta, Livia

PY - 2012/5

Y1 - 2012/5

N2 - BACKGROUND: The aim of this study was to investige serial changes of myocardial deformation using two-dimensional speckle-tracking echocardiographic (2DSTE) imaging in children undergoing balloon valvuloplasty for congenital valvular aortic stenosis (VAS).METHODS: Thirty-seven children with isolated congenital VAS were enrolled in this study prospectively. Patients underwent echocardiographic evaluation at three instances: before balloon valvuloplasty, 6 months after intervention, and 3 years after intervention. Longitudinal, circumferential, and radial peak systolic strain values were determined, as well as systolic strain rate and the time to peak global systolic strain. Linear mixed statistical models were used to assess changes in 2DSTE parameters after balloon intervention. Using one-way analysis of variance, 2DSTE results at 3-year follow-up were compared with 2DSTE measurements in 74 healthy age-matched children and 76 children with uncorrected VAS whose severity of stenosis corresponded to residual stenosis of study subjects at 3-year follow-up.RESULTS: Global peak strain and strain rate measurements in all three directions were decreased before intervention compared with healthy children. Global peak strain and strain rate measurements increased significantly (P < .001) several months after balloon valvuloplasty and continued to increase at 3-year follow-up. However, at 3-year follow-up, global peak strain and strain rate in the longitudinal and circumferential directions were significantly lower (P < .001) compared with both control groups. Measurements of time to peak global systolic strain were significantly shorter at early follow-up compared with measurements before intervention (P < .05).CONCLUSIONS: Shortly after balloon valvuloplasty for severe congenital VAS, there is an improvement in systolic myocardial deformation. However, 2DSTE parameters do not return to normal at 3-year follow-up. These abnormalities in systolic deformation cannot be fully attributed to residual stenosis or aortic regurgitation.

AB - BACKGROUND: The aim of this study was to investige serial changes of myocardial deformation using two-dimensional speckle-tracking echocardiographic (2DSTE) imaging in children undergoing balloon valvuloplasty for congenital valvular aortic stenosis (VAS).METHODS: Thirty-seven children with isolated congenital VAS were enrolled in this study prospectively. Patients underwent echocardiographic evaluation at three instances: before balloon valvuloplasty, 6 months after intervention, and 3 years after intervention. Longitudinal, circumferential, and radial peak systolic strain values were determined, as well as systolic strain rate and the time to peak global systolic strain. Linear mixed statistical models were used to assess changes in 2DSTE parameters after balloon intervention. Using one-way analysis of variance, 2DSTE results at 3-year follow-up were compared with 2DSTE measurements in 74 healthy age-matched children and 76 children with uncorrected VAS whose severity of stenosis corresponded to residual stenosis of study subjects at 3-year follow-up.RESULTS: Global peak strain and strain rate measurements in all three directions were decreased before intervention compared with healthy children. Global peak strain and strain rate measurements increased significantly (P < .001) several months after balloon valvuloplasty and continued to increase at 3-year follow-up. However, at 3-year follow-up, global peak strain and strain rate in the longitudinal and circumferential directions were significantly lower (P < .001) compared with both control groups. Measurements of time to peak global systolic strain were significantly shorter at early follow-up compared with measurements before intervention (P < .05).CONCLUSIONS: Shortly after balloon valvuloplasty for severe congenital VAS, there is an improvement in systolic myocardial deformation. However, 2DSTE parameters do not return to normal at 3-year follow-up. These abnormalities in systolic deformation cannot be fully attributed to residual stenosis or aortic regurgitation.

KW - Adolescent

KW - Age Factors

KW - Analysis of Variance

KW - Anthropometry

KW - Aortic Valve Stenosis/congenital

KW - Case-Control Studies

KW - Catheterization/methods

KW - Child, Preschool

KW - Echocardiography, Doppler/methods

KW - Echocardiography, Doppler, Color/methods

KW - Female

KW - Follow-Up Studies

KW - Heart Defects, Congenital/diagnostic imaging

KW - Humans

KW - Infant, Newborn

KW - Linear Models

KW - Male

KW - Multivariate Analysis

KW - Reference Values

KW - Retrospective Studies

KW - Risk Assessment

KW - Sex Factors

KW - Treatment Outcome

KW - Ventricular Function/physiology

KW - Ventricular Remodeling/physiology

U2 - 10.1016/j.echo.2012.01.009

DO - 10.1016/j.echo.2012.01.009

M3 - Article

C2 - 22342228

SN - 0894-7317

VL - 25

SP - 473

EP - 485

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

IS - 5

ER -

Persistent reduction in left ventricular strain using two-dimensional speckle-tracking echocardiography after balloon valvuloplasty in children with congenital valvular aortic stenosis

Abstract

Keywords

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