Table 1. Studies evaluating strain in valvular heart disease with speckle tracking echocardiography.
| Study | Sample size with description | Imaging modality (vendor name) | Objective | Outcomes | ||||
|---|---|---|---|---|---|---|---|---|
| Aortic Regurgitation | ||||||||
| Mizariene et al. [41] | Chronic AR:NT-proBNP<400 (n=44) vs. >400 vs. controls (n=64) | 2D-STE (EchoPac-GE) | Effect of LV strain on NT-proBNP | GLS>-16% predicts levels>400 | ||||
| Olsen et al. [5] | Chronic AR: Surgical (n=29) vs. conservative (n=35) | 2D-STE (EchoPAC-GE) | Strain indices in AR progression | Progression correlates with reduced systolic (-1.04 vs. -1.19s-1), early diastolic (1.2 vs. 1.6s-1) and myocardial SR (-16.3 vs. -19%) | ||||
| Smedsrud et al. [6] | Chronic AR (n=47) vs. controls (n=31) | 2D-STE (EchoPAC-GE) | GLS impairment and early LV dysfunction | Reduced GLS (-17.5 vs.-22.1%) identifies subclinical LV dysfunction; GLS and not LVEF correlates with post-operative LV function | ||||
| Kaneko et al. [37] | Chronic AR (n=36) vs. controls (n=15) | 2D-STE (Toshiba) | GRS decline-marker of myocardial dysfunction? | Endocardial GRS loss (28.9 vs. 37.1%) predicts myocardial dysfunction | ||||
| Di Salvo et al. [4] | Stable (n=17) vs. progressive AR (n=9) | 2D-STE (EchoPAC) | Strain parameters and AR progression | LV LS (cut-off >-19.5%) - only predictor for AR Progression | ||||
| Aortic Stenosis | ||||||||
| Van Dalen et al. [11] | AS (n=60) vs. controls (n=30) | 2D-STE (QLAB-Philips) | Twist indices and severity of AS, subendocardial ischemia | Elevated peak systolic LV twist (13.6 vs. 11.4) and endocardial twist-shortening ratio (0.6vs.0.4) correlates with ischemia and AS severity | ||||
| Ng et al. [9] | Aortic sclerosis (n=118) vs. Mild (n=81) vs. moderate (n=109) vs. severe (n=112) AS | 2D-STE (EchoPAC-GE) | Strain and severity of AS | Sequential deterioration in LS, CS, RS and SR correlates with progressive reduction in valve area | ||||
| Levy et al. [42] | Severe symptomatic AS | 2D-STE (EchoPAC-GE) | GLS on post-surgical atrial fibrillation rates | GLS>-15% predicts post-surgical atrial fibrillation | ||||
| Delgado et al. [10] | Severe AS (n=73) vs. controls (n=40) | 2D-STE (EchoPAC-GE) | Changes in LV strain pre and post-surgery | GLS (-14.6 vs. -20.3%) and SR-impaired despite pEF. LS, CS and RS improved following valve replacement | ||||
| Mitral Stenosis | ||||||||
| Ozdemir et al. [12] | Mild-moderate MS (n=60) vs. controls (n=52) | 2D-ECHO, STE (EchoPAC-GE) | LV dysfunction in MS with pEF | GLS (-17 vs.-19%) and GLS rate compromised in MS | ||||
| Mitral Regurgitation | ||||||||
| Isla et al. [7] | Chronic severe MR (n=38) | 2D, 3D-ECHO, Doppler ECHO and 2D-STE (Q-Lab) | Preoperative strain on post-operative LV dysfunction | Longitudinal SR at mid interventricular septal level <-0.8s-1 -best predictors of LVEF reduction > 10% | ||||
| Kim et al. [43] | Chronic severe MR (n=59) vs. controls (n=34) | 2D-ECHO,angiography and 2D-STE (EchoPac-GE) | Strain assessment of latent LV dysfunction | Peak systolic radial SR of 2.0 s-1 best correlates with peak dP/dt; short axis function offers better prediction | ||||
| Study | Sample size with description | Imaging modality (vendor name) | Objective | Outcomes | ||||
| Florescu et al. [8] | Severe primary MR (n=28) vs. controls (n=10) | 2D-ECHO, TVI and STE (EchoPac-GE) | Pre-op strain and post-valve replacement LV function | Systolic TVI and the combination of systolic TVI and LS are main independent predictors of post-operative LVEF drop >10% | ||||
| Pandis et al. [44] | Degenerative MR (n=40) | 2D, 3D-ECHO, and 2D-STE (TomTec) | Predictors of recurrent MR post-surgery | Mid-lateral RS≤-27 and apical lateral RS ≤-25-significant predictors | ||||
| Mascle et al. [45] | Severe degenerative MR: post op LVEF≥50% (n=73) + LVEF<50% (n=15) | 2D-ECHO, 2D-STE and TDI (EchoPAC-GE) | Pre-operative GLS on post-operative LV dysfunction | GLS >-18% predicts post-operative LVEF drop to <50% | ||||
2D, 2 dimensional; 3D, 3 dimensional; AS, aortic stenosis; AR, aortic regurgitation; CS, circumferential strain; ECHO, echocardiography; GLS, global longitudinal strain; GRS, global radial strain; LS, longitudinal strain; LV, left ventricle; LVEF, left ventricular ejection fraction; MS, mitral stenosis; MR, mitral regurgitation; NT-proBNP, N terminal-pro brain natriuretic peptide; pEF, preserved ejection fraction; RS, radial strain; SR, strain rate; TDI, tissue Doppler imaging; TVI, tissue velocity imaging.