title: LV mechanics in mitral and aortic valve diseases: value of functional assessment beyond ejection fraction.
abstract: The assessment of myocardial function in the context of valvular heart disease remains highly challenging. The myocardium deforms simultaneously in 3 dimensions, and global left ventricular (LV) function parameters such as volume and ejection fraction may remain compensated despite the changes in myocardial deformation properties. Current guidelines recommend valve replacement/repair in the presence of symptoms or reduced LV ejection fraction, but the resolution of symptoms or recovery of LV function post-surgery may not be reliably predicted. A wealth of evidence currently suggests that LV dysfunction is frequently subclinical despite normal ejection fraction. It may precede the onset of symptoms and portend a poor outcome due to progressive myocardial remodeling and dysfunction during the post-operative period. The advent of novel tissue-tracking echocardiography techniques has unleashed new opportunities for the clinical identification of early abnormalities in LV function. This review gathers and summarizes current evidence regarding the use of these techniques to assess myocardial deformation in patients with valvular heart disease.
authors.affiliation: Service de Cardiologie, Centre Hospitalier Universitaire de Rennes, Laboratiore Traitement du Signal et de l'Image, Institut National de la Santé et de la Recherche Médicale U 1099, Université Rennes 1, Rennes, France.
authors.forename: Elena
authors.initials: E
authors.lastname: Galli
authors.affiliation: Department of Cardiology, Groupe Interdisciplinaire de Génoproteéomique Appliquée-Cardiovascular Sciences, Centre Hospitalier Universitaire de Sart Tilman, University of Liège Hospital, Liège, Belgium.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Lancellotti
authors.affiliation: Cardiac Ultrasound Research and Core Lab, Mount Sinai Medical Center, New York, New York.
authors.forename: Partho P
authors.initials: PP
authors.lastname: Sengupta
authors.affiliation: Service de Cardiologie, Centre Hospitalier Universitaire de Rennes, Laboratiore Traitement du Signal et de l'Image, Institut National de la Santé et de la Recherche Médicale U 1099, Université Rennes 1, Rennes, France. Electronic address: erwan.donal@chu-rennes.fr.
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
mesh_terms: D000818:Animals; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D015150:Echocardiography, Doppler; D006349:Heart Valve Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D020127:Recovery of Function; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
keywords: deformation imaging; left ventricular function; speckle tracking echocardiography; valvular heart disease