{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T04:16:56Z","timestamp":1775103416812,"version":"3.50.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"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":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>In patients with bicuspid aortic valve (BAV) and preserved left ventricular (LV) ejection fraction (EF), the frequency of impaired LV global longitudinal strain (GLS) and its prognostic implications are unknown. The present study evaluated the proportion and prognostic value of impaired LV GLS in patients with BAV and preserved LVEF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Five hundred and thirteen patients (68% men; mean age 44\u2009\u00b1\u200918\u2009years) with BAV and preserved LVEF (&amp;gt;50%) were divided into five groups according to the type of BAV dysfunction: (i) normal function BAV, (ii) mild aortic stenosis (AS) or aortic regurgitation (AR), (iii) \u2265moderate isolated AS, (iv) \u2265moderate isolated AR, and (v) \u2265moderate mixed AS and AR. LV systolic dysfunction based on 2D speckle-tracking echocardiography was defined as a cut-off value of LVGLS (\u221213.6%). The primary outcome was aortic valve intervention or all-cause mortality. The proportion of patients with LVGLS \u2264\u221213.6% was the highest in the normal BAV group (97%) and the lowest in the group with moderate and severe mixed AS and AR (79%). During a median follow-up of 10\u2009years, 210 (41%) patients underwent aortic valve replacement and 17 (3%) died. Patients with preserved LV systolic function (LVGLS \u2264 \u221213.6%) had significantly better event-free survival compared to those with impaired LV systolic function (LVGLS &amp;gt; \u221213.6%). LVGLS was independently associated with increased risk of events (mainly aortic valve replacement): hazard ratio 1.09; P\u2009&amp;lt;\u20090.001.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Impaired LVGLS in BAV with preserved LVEF is not infrequent and was independently associated with increased risk of events (mainly aortic valve replacement events).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jez252","type":"journal-article","created":{"date-parts":[[2019,10,8]],"date-time":"2019-10-08T19:27:03Z","timestamp":1570562823000},"page":"759-767","source":"Crossref","is-referenced-by-count":24,"title":["Prognostic implications of left ventricular global longitudinal strain in patients with bicuspid aortic valve disease and preserved left ventricular ejection fraction"],"prefix":"10.1093","volume":"21","author":[{"given":"William K F","family":"Kong","sequence":"first","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands"},{"name":"Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore"}]},{"given":"E Mara","family":"Vollema","sequence":"first","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands"}]},{"given":"Francesca","family":"Prevedello","sequence":"first","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands"}]},{"given":"Rebecca","family":"Perry","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Flinders Medical Centre, Bedford Park, Adelaide, Australia"}]},{"given":"Arnold C T","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, Australia"}]},{"given":"Kian Keong","family":"Poh","sequence":"first","affiliation":[{"name":"Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore"}]},{"given":"Ana G","family":"Almeida","sequence":"first","affiliation":[{"name":"Cardiology Department, Santa Maria University Hospital (CHLN), CAML, CCUL, Lisbon School of Medicine of the Universidade de Lisboa, Portugal"}]},{"given":"Ariana","family":"Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Ram\u00f3n y Cajal, Madrid, Spain"}]},{"given":"Myl\u00e8ne","family":"Shen","sequence":"first","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, Canada"}]},{"given":"Tiong Cheng","family":"Yeo","sequence":"first","affiliation":[{"name":"Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore"}]},{"given":"Miriam","family":"Shanks","sequence":"first","affiliation":[{"name":"Division of Cardiology, University of Alberta, Mazankowski Alberta Heart Institute, Canada"}]},{"given":"Bogdan A","family":"Popescu","sequence":"first","affiliation":[{"name":"University of Medicine and Pharmacy \u201cCarol Davila\u201d\u2014Euroecolab, Institute of Cardiovascular Diseases \u201cProf. Dr. C. C. Iliescu\u201d, Bucharest, Romania"}]},{"given":"Laura","family":"Galian Gay","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Universitari Vall d\u2019Hebr\u00f3n, Barcelona, Spain"}]},{"given":"Marcin","family":"Fija\u0142kowski","sequence":"first","affiliation":[{"name":"First Department of Cardiology, Medical University of Gdansk, Poland"}]},{"given":"Michael","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore"},{"name":"Department of Cardiology, Khoo Teck Puat Hospital, Singapore, Singapore"}]},{"given":"Ruth W","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore"}]},{"given":"Nina","family":"Ajmone Marsan","sequence":"first","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, 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