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Prognostic value of tissue-tracking mitral annular displacement by speckle-tracking echocardiography in asymptomatic aortic stenosis patients with preserved left ventricular ejection fraction

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Abstract

Background

Tissue-tracking mitral annular displacement (TMAD) by speckle-tracking echocardiography provides rapid and simple assessment of left ventricular (LV) longitudinal deformation. The purpose of this study was to evaluate the value of TMAD for the assessment of LV longitudinal deformation in patients with severe AS and preserved LV ejection fraction (LVEF).

Methods

We studied 44 patients with severe AS preserved and LVEF in whom TMAD was assessed. Using TMAD analysis software, the base-to-apex displacement of automatically defined mid-point of mitral annular line in four-chamber view was quickly assessed, and the percentage of its displacement to LV length at end-diastole (%TMAD) was calculated. We investigated the association between %TMAD and the cardiac events including appearance of symptom (dyspnea on exertion and hospitalization due to heart failure), decreased LVEF (< 50%), and cardiac death.

Results

During follow-up, the cardiac events developed in 16 (36%) of 44 patients. %TMAD was significantly impaired in patients with the cardiac events compared with those without the cardiac events (9.6 ± 1.9 vs 12.1 ± 2.6, p = 0.002). The cardiac events were predicted by %TMAD (HR 0.68, 95% CI 0.54–0.85; p = 0.0012).

Conclusions

The present study suggests that TMAD easily and rapidly estimated by speckle-tracking echocardiography may be used as a simple method to predict occurrence of the cardiac events in asymptomatic severe AS patients with preserved LVEF.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan

    Ikuko Teraguchi, Takeshi Hozumi, Hiroki Emori, Kazushi Takemoto, Suwako Fujita, Teruaki Wada, Manabu Kashiwagi, Yasutsugu Shiono, Kunihiro Shimamura, Akio Kuroi, Takashi Tanimoto, Takashi Kubo, Atsushi Tanaka & Takashi Akasaka

Authors
  1. Ikuko Teraguchi
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  2. Takeshi Hozumi
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  3. Hiroki Emori
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  4. Kazushi Takemoto
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  5. Suwako Fujita
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  13. Atsushi Tanaka
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  14. Takashi Akasaka
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Corresponding author

Correspondence to Takeshi Hozumi.

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Conflict of interest

Ikuko Teraguchi, Takeshi Hozumi, Hiroki Emori, Kazushi Takemoto, Suwako Fujita, Teruaki Wada, Manabu Kashiwagi, Yasutsugu Shiono, Kunihiro Shimamura, Akio Kuroi, Takashi Tanimoto, Takashi Kubo, Atsushi Tanaka, and Takashi Akasaka declare that they have no conflict of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

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Informed consent was obtained from all patients for being included in the study.

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Teraguchi, I., Hozumi, T., Emori, H. et al. Prognostic value of tissue-tracking mitral annular displacement by speckle-tracking echocardiography in asymptomatic aortic stenosis patients with preserved left ventricular ejection fraction. J Echocardiogr 19, 95–102 (2021). https://doi.org/10.1007/s12574-020-00490-w

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  • DOI: https://doi.org/10.1007/s12574-020-00490-w

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