Brief Title
Prognostic Impact of Myocardial Longitudinal Strain in Asymptomatic Aortic Stenosis: a Meta-Analysis
Official Title
Prognostic Impact of Myocardial Longitudinal Strain in Asymptomatic Aortic Stenosis: a Meta-Analysis
Brief Summary
In patients with asymptomatic aortic stenosis (AS), the prognostic value of reduced left ventricular (LV) ejection fraction is well known. Consequently, there is class I indication for surgery in these patients when LV ejection fraction <50%. However, there is growing evidences suggesting that subclinical LV dysfunction, and more particularly longitudinal myocardial dysfunction, may be a powerful early predictor of outcome, even when LV ejection is still preserved. In asymptomatic AS patients with LV ejection fraction >50%, a reduced LV global longitudinal strain, as assessed using speckle tracking imaging with transthoracic echocardiography, may be an accurate marker to identify early subclinical LV dysfunction and thus, to improve the risk stratification, the management and the timing of surgery. Several mono-centric observational small studies recently reported results emphasizing the role of LV global longitudinal strain in AS patients. Therefore, a meta-analysis may be conducted and may provide meaningful data. The investigators hypothesized that LV global longitudinal strain is a determinant of outcome in asymptomatic patients with AS and preserved LV ejection fraction.
Study Type
Observational
Primary Outcome
Combined outcome of death and cardiovascular-related hospitalization (including aortic valve replacement)
Secondary Outcome
Combined outcome of death and cardiovascular-related hospitalization (without aortic valve replacement)
Condition
Aortic Valve Stenosis
Study Arms / Comparison Groups
Preserved LV GLS
Description: Patients will be compared according to the level of LV global longitudinal strain (GLS) as derived from transthoracic echocardiography and speckle tracking analysis. Two groups will be compared regarding outcome: preserved LV GLS vs. reduced LV GLS. The definition use for reduced LV GLS will be >-16%. An optimal threshold would also be calculated and derived from the pooled data.
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Estimated Enrollment
1000
Start Date
October 2015
Completion Date
December 2017
Primary Completion Date
December 2016
Eligibility Criteria
Inclusion Criteria: - studies selected in PubMed, Embase, Ovid, and Google Scholar, published between 2005 and 2015 without language restriction according to the following criteria: "aortic stenosis" AND "longitudinal strain" Exclusion Criteria: - Studies reporting global longitudinal strain derived from VVI and not speckle tracking analysis. - Studies with cohort of patients with aortic valve replacement indication
Gender
All
Ages
18 Years - N/A
Accepts Healthy Volunteers
No
Contacts
Erwan Donal, MD, PhD, ,
Location Countries
France
Location Countries
France
Administrative Informations
NCT ID
NCT02608567
Organization ID
EACVI-001
Responsible Party
Principal Investigator
Study Sponsor
European Association of Cardiovascular Imaging
Study Sponsor
Erwan Donal, MD, PhD, Study Chair, European Association of Cardiovascular Imaging
Verification Date
February 2017