Key result
Bicuspid aortic valve patients exhibit reduced GLS versus healthy controls, worsening progressively with increasing AS.
Why the study?
The effects of aortic stenosis progression on multidirectional myocardial function in BAV patients have not been elucidated.
Does aortic stenosis severity correlate with multidirectional myocardial dysfunction measured by 3D-STE in patients with bicuspid aortic valve?
Cross-Sectional (n=116)
No
Does aortic stenosis severity correlate with multidirectional myocardial dysfunction measured by 3D-STE in patients with bicuspid aortic valve?
Absolute Event Rate: -23.53% vs -26.93%
p-value: p=<0.001
In patients with bicuspid aortic valve, multidirectional myocardial function measured by 3D-STE progressively worsens with increasing aortic stenosis severity, with longitudinal and radial strain impairment beginning even before significant stenosis develops.
GLS reduction may mark early dysfunction in BAV; leaves open whether 3D-STE refines risk stratification in prospective cohorts.
Purpose The effects of aortic stenosis (AS) progression on multidirectional myocardial function in BAV patients has still not elucidated, although early left ventricular longitudinal myocardial dysfunction is known to be presented in BAV patients with normal function. The aim of the study was to evaluate the multidirectional myocardial functions of BAV patients. Methods A total of 86 BAV patients (age 46.71 ± 13.62 years, 69.4% men) with normally functioning (BAV-nf), mild AS, moderate AS, and severe AS with preserved left ventricular ejection fraction (LVEF ≥ 50%) were included. 30 healthy volunteers were recruited as the control group. Multidirectional strain and volume analysis were performed by three-dimensional speckle tracking echocardiography(3D-STE). Results Global longitudinal strain (GLS), and global radial strain (GRS) were reduced in BAV-nf patients compared with the controls. With each categorical the increase of AS severity from BAV-nf to severe AS, there was an associated progressive impairment of GLS and GRS (all P < 0.001). The global circumferential strain (GCS) did not change significantly from BAV-nf to mild AS but was starting damaged from moderate AS. Multiple linear regressions indicated that indexed aortic valve area (AVA/BSA), as a measure of AS severity, was an independent determinant of GLS, GCS and GRS. Conclusions Left ventricular myocardial damage occurs earlier in BAV patients. With each categorical increase in the grade of AS severity from normally functioning to severe aortic stenosis, there was an associated progressive impairment of longitudinal myocardial. Furthermore, circumferential myocardial function was starting damaged from moderate AS. AVA/BSA was independently associated with multidirectional myocardial function injuries.
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Deng et al. (2024) conducted a cross-sectional in Bicuspid aortic valve stenosis (n=116). Bicuspid aortic valve (normally functioning) vs. Healthy controls was evaluated on Global longitudinal strain (GLS) (p=<0.001). Bicuspid aortic valve patients exhibited significantly reduced global longitudinal strain compared to healthy controls (-23.53% vs -26.93%), which progressively worsened with increasing aortic stenosis.
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