Multi-chamber three-dimensional myocardial strain assessment by computed tomography: a comparison with speckle tracking echocardiography and association with pulmonary hypertension in severe aortic stenosis - Scorecard - MDSpire
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Multi-chamber three-dimensional myocardial strain assessment by computed tomography: a comparison with speckle tracking echocardiography and association with pulmonary hypertension in severe aortic stenosis
Clinical Scorecard: Three-Dimensional Myocardial Strain Evaluation Using Computed Tomography: A Comparative Analysis with Speckle Tracking Echocardiography and Its Relationship to Pulmonary Hypertension in Severe Aortic Stenosis
At a Glance
Category
Detail
Condition
Severe Aortic Stenosis (AS)
Key Mechanisms
Evaluation of myocardial strain using 3D CT and 2D TTE to assess cardiac function and pulmonary hypertension.
Target Population
Adult patients (>18 years) with severe symptomatic AS undergoing TAVI evaluation.
Care Setting
Cardiology, specifically in the context of transcatheter aortic valve implantation (TAVI) planning.
Key Highlights
Strong agreement between CT and TTE for LV-GLS and RV-GLS.
CT-derived strain values are lower than TTE for identifying high probability pulmonary hypertension.
TTE-derived LV-GLS is superior for detecting high probability pulmonary hypertension compared to CT-derived LV-GLS.
Both CT and TTE-derived strain measurements show excellent reproducibility.
Myocardial strain imaging is a promising tool for assessing extra-valvular remodeling in AS.
Guideline-Based Recommendations
Diagnosis
Severe AS defined by AVA < 1 cm2 or mean gradient ≥40 mmHg or peak jet velocity ≥4 m/s.
Pulmonary hypertension defined using TTE criteria including peak tricuspid regurgitation jet velocity.
Management
Consider TAVI for patients with severe symptomatic AS.
Monitoring & Follow-up
Regular assessment of myocardial strain and pulmonary hypertension status in patients with AS.
Risks
Increased mortality associated with impaired longitudinal strain in AS patients undergoing TAVI.
Patient & Prescribing Data
93 patients with severe symptomatic AS.
Utilization of TAVI as a treatment option, with emphasis on strain imaging for risk stratification.
Clinical Best Practices
Incorporate 3D CT-derived strain assessment in TAVI planning.
Use TTE for routine strain analysis while acknowledging its limitations.
Evaluate pulmonary hypertension status in AS patients to guide management.
