PMID- 25212549
OWN - NLM
STAT- MEDLINE
DCOM- 20141113
LR  - 20161125
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 114
IP  - 7
DP  - 2014 Oct 1
TI  - Myocardial deformation imaging by two-dimensional speckle-tracking 
      echocardiography in comparison to late gadolinium enhancement cardiac magnetic 
      resonance for analysis of myocardial fibrosis in severe aortic stenosis.
PG  - 1083-8
LID - S0002-9149(14)01446-5 [pii]
LID - 10.1016/j.amjcard.2014.07.018 [doi]
AB  - Myocardial deformation analysis by speckle-tracking echocardiography (STE) has 
      been used for analysis of myocardial viability and myocardial fibrosis. Patients 
      with severe aortic stenosis are known to develop myocardial fibrosis. This study 
      evaluated the association between myocardial fibrosis determined by late 
      gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) and 2-dimensional 
      STE in patients with severe aortic stenosis. In 30 patients (78+/-7 years) with 
      severe aortic stenosis (mean gradient 53+/-21 mm Hg), peak systolic circumferential 
      strain based on 2-dimensional echocardiographic parasternal short-axis views and 
      peak systolic longitudinal strain based on apical views were determined for 
      analysis of regional function. LGE CMR was performed to define the amount of 
      fibrosis in each segment within 24 hours of echocardiography. Relative amount of 
      fibrosis was determined based on LGE CMR as gray-scale threshold 6 SDs above the 
      mean signal intensity of the normal remote myocardium. There was a decrease in 
      LGE from base to apex (14.4+/-8.7% for basal segments, 3.4+/-3.0% for midventricular 
      segments, and 2.1+/-3.0% for apical segments; p<0.001). Simultaneously, there was 
      an increase in myocardial deformation expressed as peak systolic longitudinal 
      strain from base to apex (-11.6+/-7.0% for basal segments, -16.9+/-6.5% for 
      midventricular segments, and -17.4+/-7.7% for apical segments; p=0.001). There was 
      a negative correlation between the amount of myocardial fibrosis determined by 
      LGE CMR and peak systolic longitudinal strain for the total left ventricle 
      (r=-0.538, p=0.007). Myocardial fibrosis defined as LGE>10% could be identified 
      by peak systolic longitudinal strain less than -11.6%, with a sensitivity of 65% 
      and a specificity of 75% (area under the receiver operating characteristic curve 
      0.69). In conclusion, myocardial fibrosis increases from apical to basal left 
      ventricular segments in patients with severe aortic stenosis. There is an 
      association between severity of myocardial fibrosis defined by LGE CMR and 
      myocardial deformation by STE.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Hoffmann, Rainer
AU  - Hoffmann R
AD  - Department of Cardiology, Pneumology, Angiology and Intensive Care, University 
      Hospital RWTH Aachen, Aachen, Germany. Electronic address: rhoffmann@UKAACHEN.de.
FAU - Altiok, Ertunc
AU  - Altiok E
AD  - Department of Cardiology, Pneumology, Angiology and Intensive Care, University 
      Hospital RWTH Aachen, Aachen, Germany.
FAU - Friedman, Zvi
AU  - Friedman Z
AD  - Department of Biomedical Engineering, Technion, Haifa, Israel.
FAU - Becker, Michael
AU  - Becker M
AD  - Department of Cardiology, Pneumology, Angiology and Intensive Care, University 
      Hospital RWTH Aachen, Aachen, Germany.
FAU - Frick, Michael
AU  - Frick M
AD  - Department of Cardiology, Pneumology, Angiology and Intensive Care, University 
      Hospital RWTH Aachen, Aachen, Germany.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140718
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/complications/*diagnosis
MH  - Cardiomyopathies/*diagnosis/etiology
MH  - Contrast Media
MH  - Echocardiography/*methods
MH  - Female
MH  - Fibrosis/diagnosis
MH  - *Gadolinium DTPA
MH  - Heart Ventricles/*diagnostic imaging/pathology
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Myocardium/*pathology
MH  - Observer Variation
MH  - Reproducibility of Results
MH  - Severity of Illness Index
MH  - Time Factors
EDAT- 2014/09/13 06:00
MHDA- 2014/11/14 06:00
CRDT- 2014/09/13 06:00
PHST- 2014/04/17 00:00 [received]
PHST- 2014/07/02 00:00 [revised]
PHST- 2014/07/02 00:00 [accepted]
PHST- 2014/09/13 06:00 [entrez]
PHST- 2014/09/13 06:00 [pubmed]
PHST- 2014/11/14 06:00 [medline]
AID - S0002-9149(14)01446-5 [pii]
AID - 10.1016/j.amjcard.2014.07.018 [doi]
PST - ppublish
SO  - Am J Cardiol. 2014 Oct 1;114(7):1083-8. doi: 10.1016/j.amjcard.2014.07.018. Epub 
      2014 Jul 18.