{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T15:27:22Z","timestamp":1793806042118,"version":"4.6.1"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Myocardial work is a novel echocardiographic algorithm that corrects speckle-tracking-derived global longitudinal strain (GLS) for afterload using non-invasive systolic blood pressure as a surrogate for left ventricular systolic pressure (LVSP). Yet, in patients with severe aortic stenosis, non-invasive systolic blood pressure does not equal LVSP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We evaluated 35 patients with severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR). Transthoracic echocardiography, including myocardial mechanics, was performed pre- and post-TAVR. We performed simultaneous echocardiographic and cardiac catheterization measurements in 23 of the 35 patients at the time of TAVR. Peak and mean aortic gradients were calculated from echocardiographic and cardiac catheterization data. Peak-to-peak LV-aortic gradient correlated highly with mean LV-aortic gradient (r\u2009=\u20090.96); measured LVSP correlated highly with our novel method of non-invasively estimated LVSP (non-invasive systolic blood pressure cuff + Doppler-derived mean aortic gradient, r\u2009=\u20090.92). GLS improved from pre- to post-TAVR (\u221214.2% \u00b1 4.3 vs. \u221215.1% \u00b1 3.2), and myocardial work reduced from corrected pre-TAVR to post-TAVR (global work index: 1856.2\u2009mmHg% \u00b1 704.6 vs. 1534.8\u2009\u00b1\u2009385.0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We propose that non-invasive assessment of myocardial work can be reliably performed in aortic stenosis by the addition of mean aortic gradient to non-invasive systolic blood pressure. From this analysis, we note the novel and unique finding that GLS can improve as myocardial work reduces post-TAVR in patients with severe aortic stenosis. Both GLS and myocardial work post-TAVR remain below normal values, requiring further studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjci\/jeaa257","type":"journal-article","created":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T15:12:43Z","timestamp":1598454763000},"page":"715-721","source":"Crossref","is-referenced-by-count":69,"title":["Myocardial work assessment in severe aortic stenosis undergoing transcatheter aortic valve replacement"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5792-4963","authenticated-orcid":false,"given":"Renuka","family":"Jain","sequence":"first","affiliation":[{"name":"Aurora Cardiovascular and Thoracic Services, Aurora St. Luke\u2019s Medical Center, University of Wisconsin School of Medicine and Public Health, 2801 W. Kinnickinnic River Parkway, Suite 880, Milwaukee, WI 53215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanvir","family":"Bajwa","sequence":"additional","affiliation":[{"name":"Aurora Cardiovascular and Thoracic Services, Aurora St. Luke\u2019s Medical Center, University of Wisconsin School of Medicine and Public Health, 2801 W. Kinnickinnic River Parkway, Suite 880, Milwaukee, WI 53215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Roemer","sequence":"additional","affiliation":[{"name":"Aurora Cardiovascular and Thoracic Services, Aurora St. Luke\u2019s Medical Center, University of Wisconsin School of Medicine and Public Health, 2801 W. Kinnickinnic River Parkway, Suite 880, Milwaukee, WI 53215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary","family":"Huisheree","sequence":"additional","affiliation":[{"name":"Aurora Cardiovascular and Thoracic Services, Aurora St. Luke\u2019s Medical Center, University of Wisconsin School of Medicine and Public Health, 2801 W. Kinnickinnic River Parkway, Suite 880, Milwaukee, WI 53215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suhail Q","family":"Allaqaband","sequence":"additional","affiliation":[{"name":"Aurora Cardiovascular and Thoracic Services, Aurora St. Luke\u2019s Medical Center, University of Wisconsin School of Medicine and Public Health, 2801 W. Kinnickinnic River Parkway, Suite 880, Milwaukee, WI 53215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacie","family":"Kroboth","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Advocate Aurora Research, Advocate Aurora Health, 3033 S 27th Street, Parkway Building Ste. 201, Milwaukee, WI 53215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cristina","family":"Perez Moreno","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Advocate Aurora Research, Advocate Aurora Health, 3033 S 27th Street, Parkway Building Ste. 201, Milwaukee, WI 53215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A Jamil","family":"Tajik","sequence":"additional","affiliation":[{"name":"Aurora Cardiovascular and Thoracic Services, Aurora St. Luke\u2019s Medical Center, University of Wisconsin School of Medicine and Public Health, 2801 W. Kinnickinnic River Parkway, Suite 880, Milwaukee, WI 53215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijoy K","family":"Khandheria","sequence":"additional","affiliation":[{"name":"Aurora Cardiovascular and Thoracic Services, Aurora St. Luke\u2019s Medical Center, University of Wisconsin School of Medicine and Public Health, 2801 W. Kinnickinnic River Parkway, Suite 880, Milwaukee, WI 53215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,10,27]]},"reference":[{"key":"2021051021281881300_jeaa257-B1","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jcmg.2018.08.040","article-title":"Assessment of subclinical left ventricular dysfunction in aortic stenosis","volume":"12","author":"Dahl","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2021051021281881300_jeaa257-B2","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.echo.2011.01.015","article-title":"Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE\/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography","volume":"24","author":"Mor-Avi","year":"2011","journal-title":"J Am Soc Echocardiogr"},{"key":"2021051021281881300_jeaa257-B3","doi-asserted-by":"crossref","first-page":"2549","DOI":"10.1016\/j.jcmg.2019.05.028","article-title":"A roadmap to assess myocardial work: from theory to clinical practice","volume":"12","author":"van der Bijl","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2021051021281881300_jeaa257-B4","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/ehjci\/jey156","article-title":"Myocardial work by echocardiography: a novel method ready for clinical testing","volume":"20","author":"Boe","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021051021281881300_jeaa257-B5","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1093\/ehjci\/jey131","article-title":"A new approach to assess myocardial work by non-invasive left ventricular pressure-strain relations in hypertension and dilated cardiomyopathy","volume":"20","author":"Chan","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021051021281881300_jeaa257-B6","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1093\/eurheartj\/ehs016","article-title":"A novel clinical method for quantification of regional left ventricular pressure-strain loop area: a non-invasive index of myocardial work","volume":"33","author":"Russell","year":"2012","journal-title":"Eur Heart J"},{"key":"2021051021281881300_jeaa257-B7","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/j.echo.2004.12.014","article-title":"Increased right ventricular afterload induces postsystolic thickening of the ventricular septum in nonischemic hearts","volume":"18","author":"Urheim","year":"2005","journal-title":"J Am Soc Echocardiogr"},{"key":"2021051021281881300_jeaa257-B8","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1093\/ehjci\/jew019","article-title":"Wasted septal work in left ventricular dyssynchrony: a novel principle to predict response to cardiac resynchronization therapy","volume":"17","author":"Vecera","year":"2016","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021051021281881300_jeaa257-B9","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1093\/ehjci\/jez027","article-title":"Usefulness of myocardial work measurement in the assessment of left ventricular systolic reserve response to spironolactone in heart failure with preserved ejection fraction","volume":"20","author":"Przewlocka-Kosmala","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021051021281881300_jeaa257-B10","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/S0033-0620(05)80037-4","article-title":"Quantitative hemodynamics by Doppler echocardiography: a noninvasive alternative to cardiac catheterization","volume":"36","author":"Nishimura","year":"1994","journal-title":"Prog Cardiovasc Dis"},{"key":"2021051021281881300_jeaa257-B11","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1093\/ehjci\/jey188","article-title":"Echocardiographic reference ranges for normal non-invasive myocardial work indices: results from the EACVI NORRE study","volume":"20","author":"Manganaro","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021051021281881300_jeaa257-B12","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1001\/jamacardio.2016.1132","article-title":"Association of abnormal postoperative left ventricular global longitudinal strain with outcomes in severe aortic stenosis following aortic valve replacement","volume":"1","author":"Kafa","year":"2016","journal-title":"JAMA Cardiol"},{"key":"2021051021281881300_jeaa257-B13","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1093\/ehjci\/jex189","article-title":"Left ventricular global longitudinal strain is predictive of all-cause mortality independent of aortic stenosis severity and ejection fraction","volume":"19","author":"Ng","year":"2018","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021051021281881300_jeaa257-B14","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/j.amjcard.2014.07.018","article-title":"Myocardial deformation imaging by two-dimensional speckle-tracking echocardiography in comparison to late gadolinium enhancement cardiac magnetic resonance for analysis of myocardial fibrosis in severe aortic stenosis","volume":"114","author":"Hoffmann","year":"2014","journal-title":"Am J Cardiol"},{"key":"2021051021281881300_jeaa257-B15","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jcmg.2018.11.005","article-title":"Distribution and prognostic significance of left ventricular global longitudinal strain in asymptomatic significant aortic stenosis: an individual participant data meta-analysis","volume":"12","author":"Magne","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2021051021281881300_jeaa257-B16","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1016\/j.jcin.2020.03.011","article-title":"Left ventricular hypertrophy and clinical outcomes over 5 years after TAVR: an analysis of the PARTNER trials and registries","volume":"13","author":"Gonzales","year":"2020","journal-title":"JACC Cardiovasc Interv"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/22\/6\/715\/37904662\/jeaa257.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/22\/6\/715\/37904662\/jeaa257.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T18:37:57Z","timestamp":1620671877000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/22\/6\/715\/5940644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,27]]},"references-count":16,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,10,27]]},"published-print":{"date-parts":[[2021,5,10]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jeaa257","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,6,1]]},"published":{"date-parts":[[2020,10,27]]}}}