Key result
Patients with well-functioning bicuspid aortic valves had significantly increased global work index, global wasted work, and aortic stiffness index (all P<0.001) compared to controls.
Why the study?
The study aimed to analyze left ventricular myocardial work in patients with well-functioning BAV and explore the influences of aortic dilation and arterial stiffness on left ventricular function.
Does noninvasive left ventricular pressure-strain myocardial work detect early myocardial impairment in patients with well-functioning bicuspid aortic valves compared to controls?
Observational (n=154)
Does noninvasive left ventricular pressure-strain myocardial work detect early myocardial impairment in patients with well-functioning bicuspid aortic valves compared to controls?
p-value: p=<0.001
Noninvasive myocardial work indices can detect early left ventricular impairment and differentiate the detrimental effects of aortic dilation in patients with well-functioning bicuspid aortic valves better than global longitudinal strain.
May support early LV impairment detection in BAV; hypothesis-generating and requires prospective validation before practice change.
Background: Noninvasive left ventricular pressure-strain myocardial work (MW) is a novel method for evaluating left ventricular function that integrates myocardial deformation and afterload and has certain advantages over global longitudinal strain (GLS). The study aimed to analyze MW in patients with well-functioning bicuspid aortic valve (BAV) and explore the influences of aortic dilation and arterial stiffness on left ventricular function. Methods: A total of 104 patients with well-functioning BAVs and 50 controls were enrolled in our study. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE), GLS, and aortic stiffness index were measured. Based on the ascending aortic diameter, patients with BAV were divided into 3 subgroups (nondilated, mildly dilated, and moderately dilated). Results: GWI, GCW, GWW, and aortic stiffness index were significantly increased (P<0.001, P=0.023, P<0.001, and P<0.001, respectively), while GWE and GLS were significantly decreased among patients with BAV compared with controls (all P values <0.001). Patients with BAV and mildly and moderately dilated aortas had an increased GWW and aortic stiffness index but a decreased GWE compared with patients with BAV and nondilated aortas (all P values <0.05); meanwhile, GCW and GLS did not differ among the BAV subgroups (all P values >0.05). GWI was elevated in patients with BAV and moderately dilated aortas compared with patients with BAV and nondilated aortas (P<0.05). On multivariable analysis, the aortic stiffness index was an independent influencer of GWI, GCW, GWW, and GWE (P=0.025, P=0.049, P<0.001, and P=0.001, respectively). The aortic diameter was highly correlated with the aortic stiffness index (r=0.863; P<0.001). Conclusions: MW could assess early myocardial impairment in patients with well-functioning BAV. MW may help to differentiate the detrimental effect of aortic dilation on left ventricular function, whereas GLS may not.
No takes yet. Share an insight, caveat, or question.
Tan et al. (2023) conducted an observational in Well-functioning bicuspid aortic valve (n=154). Well-functioning bicuspid aortic valve vs. Controls was evaluated on Global work index, global constructive work, global wasted work, global work efficiency, global longitudinal strain, and aortic stiffness index (p=<0.001). Patients with well-functioning bicuspid aortic valves had significantly increased global work index, global wasted work, and aortic stiffness index (all P<0.001) compared to controls.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: