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. 2016 Nov;31(11):1790-1797.
doi: 10.1007/s00380-016-0803-4. Epub 2016 Feb 3.

Global area strain is a sensitive marker of subendocardial damage in adults after optimal repair of aortic coarctation: three-dimensional speckle-tracking echocardiography data

Ewa Kowalik  1 , Mirosław Kowalski  2 , Anna Klisiewicz  2 , Piotr Hoffman  2
Affiliations

Global area strain is a sensitive marker of subendocardial damage in adults after optimal repair of aortic coarctation: three-dimensional speckle-tracking echocardiography data

Ewa Kowalik et al. Heart Vessels. 2016 Nov.

Abstract

Aortic coarctation (CoA) in adults is associated with reduced survival. Despite successful repair, some unfavorable changes in the left ventricular (LV) myocardial function are reported. Three-dimensional speckle-tracking imaging (3D-STE) is a novel method that allows to assess regional myocardial function in all directions simultaneously and to calculate global area strain which integrates longitudinal and circumferential deformation. The aim of our study was to assess whether 3-D STE provides any new characteristics of LV deformation in patients with optimal CoA repair. Adults after CoA correction underwent transthoracic echocardiographic examinations. Patients with significant concomitant lesions were ruled out. Global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS) were assessed using 3D-STE (Echopac Software, GE). The data were compared with those obtained from healthy subjects. 26 adults (9F/17M; mean age 24.4 years) with repaired CoA were studied. Despite preserved LVEFs, patients with repaired CoA had decreased GAS compared with controls (-28.8 vs. -31.7 %; p = 0.007). No differences between patients and healthy subjects in terms of GLS, GCS and GRS were observed. We found a significant correlation between mean blood pressure and GAS (R = 0.39; p < 0.05). No significant influence of age at repair, CoA correction method or LV mass on three-dimensional deformation was observed. Summarizing, global area strain derived from 3D-STE may be a sensitive indicator of subclinical LV dysfunction in patients after optimal repair of CoA. Mean blood pressure, but not age at correction seems to determine LV deformation.

Keywords: Aortic coarctation; Area strain; Left ventricular function; Speckle-tracking echocardiography; Three-dimensional imaging.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
An example of 3D-STE analysis
Fig. 2
Fig. 2
The correlation between mean BP and GAS in CoA patients (r = 0.39; p < 0.05)
Fig. 3
Fig. 3
Bland–Altman plot for intra-observer difference of the global area strain
Fig. 4
Fig. 4
Bland–Altman plot for inter-observer difference of the global area strain
See this image and copyright information in PMC

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