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 - Summary - 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
To evaluate the agreement and reproducibility of CT- and TTE-derived longitudinal strain and examine its association with pulmonary hypertension in significant aortic stenosis, highlighting its clinical significance.
Key Findings:
Strong agreement between CT and TTE for LV-GLS (r = 0.837), RV-GLS (r = 0.853), and RV-FWLS (r = 0.780); moderate for LA-LS (r = 0.677), with sample sizes noted.
Peak longitudinal strain significantly reduced in H-PH compared to L-PH (p < 0.001), with sample sizes included.
Optimal strain cutoff values for identifying H-PH were lower on CT than on TTE.
TTE-derived LV-GLS was superior to CT-derived LV-GLS for detecting H-PH (AUC: 0.94 vs. 0.85, p = 0.013).
Excellent reproducibility for both TTE and CT-derived strain measurements (ICC > 0.9).
Interpretation:
TAVI CT provides a promising method for 3D longitudinal strain assessment, complementing TTE in evaluating myocardial remodelling associated with aortic stenosis and pulmonary hypertension, with implications for clinical practice.
Limitations:
Limited data on the prognostic value of multi-chamber CT-derived 3D strain in aortic stenosis, including potential biases.
Study population may not represent all patients with aortic stenosis, suggesting caution in generalization.
Conclusion:
Further studies are warranted to evaluate the prognostic value of multi-chamber CT-derived 3D strain in aortic stenosis, emphasizing the importance of this research for future clinical applications.
