{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T08:21:11Z","timestamp":1765268471045,"version":"3.37.3"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,1,21]],"date-time":"2018-01-21T00:00:00Z","timestamp":1516492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006356","name":"Syddansk Universitet","doi-asserted-by":"publisher","award":["22.000 USD"],"award-info":[{"award-number":["22.000 USD"]}],"id":[{"id":"10.13039\/501100006356","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007405","name":"Hjerteforeningen","doi-asserted-by":"publisher","award":["25.000 USD"],"award-info":[{"award-number":["25.000 USD"]}],"id":[{"id":"10.13039\/100007405","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Speckle tracking echocardiography is considered valuable in assessing left ventricular (<jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>) function. The method has been refined to assess deformation in different myocardial layers, but the effect of volume vs pressure overload on this pattern is unknown. The aim was to test whether layer\u2010specific myocardial strain (<jats:styled-content style=\"fixed-case\">LSS<\/jats:styled-content>) obtained by speckle tracking echocardiography exhibits different patterns in conditions with different loading conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Forty patients with asymptomatic severe aortic stenosis (<jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>) (<jats:styled-content style=\"fixed-case\">AVA<\/jats:styled-content> 0.81\u00a0\u00b1\u00a00.15\u00a0cm<jats:sup>2<\/jats:sup>, <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> ejection fraction [<jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>] 66%\u00a0\u00b1\u00a07%), 43 patients with asymptomatic or mildly symptomatic significant primary mitral regurgitation (<jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content>) (effective regurgitant orifice (<jats:styled-content style=\"fixed-case\">ERO<\/jats:styled-content>) 0.51 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 0.37\u20130.67)\u00a0cm<jats:sup>2<\/jats:sup>, <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content> 70%\u00a0\u00b1\u00a07%), and 23 healthy individuals (<jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content> 65%\u00a0\u00b1\u00a06%) were enrolled. Echocardiography and right heart catheterization were performed in all patients. In <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content>, strain values in each myocardial layer (endocardial\/global longitudinal strain (<jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content>)\/epicardial) were higher (25.0%\u00a0\u00b1\u00a03.4%\/21.6%\u00a0\u00b1\u00a02.9%\/18.8%\u00a0\u00b1\u00a02.6%) compared to healthy individuals (22.6%\u00a0\u00b1\u00a03.2%\/19.6%\u00a0\u00b1\u00a02.9%\/17.1%\u00a0\u00b1\u00a02.6%) and <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> (20.5%\u00a0\u00b1\u00a02.8%\/17.7%\u00a0\u00b1\u00a02.5%\/14.0%\u00a0\u00b1\u00a05.6%), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001. All 3 groups exhibited a similar <jats:styled-content style=\"fixed-case\">LSS<\/jats:styled-content> pattern with highest values in the endocardial and lowest values in the epicardial layer. The epicardial\u2010endocardial strain ratio was lower in <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> (0.72\u00a0\u00b1\u00a00.04) than in <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content> (0.75\u00a0\u00b1\u00a00.04, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04). Global longitudinal strain (<jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content>) correlated significantly with <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> wall stress (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.39, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.0003) but not with <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> stroke work or contractility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Layer\u2010specific myocardial strain (<jats:styled-content style=\"fixed-case\">LSS<\/jats:styled-content>) patterns differed in patients with severe <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>, significant <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content>, and healthy individuals with highest values in <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content>. Strain irrespective of layer assessed was associated with <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> wall stress but seemed less related to contractility and unrelated to stroke work in the setting of normal <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13747","type":"journal-article","created":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T15:09:59Z","timestamp":1516633799000},"page":"170-178","source":"Crossref","is-referenced-by-count":3,"title":["Layer\u2010specific deformation analysis in severe aortic valve stenosis, primary mitral valve regurgitation, and healthy individuals validated against invasive hemodynamic measurements of heart function"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1182-8458","authenticated-orcid":false,"given":"Rine","family":"Bakkestr\u00f8m","sequence":"first","affiliation":[{"name":"Department of Cardiology Odense University Hospital  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolaj L.","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Odense University Hospital  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emil","family":"Wolsk","sequence":"additional","affiliation":[{"name":"The Heart Center Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Banke","sequence":"additional","affiliation":[{"name":"Department of Cardiology Odense University Hospital  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordi S.","family":"Dahl","sequence":"additional","affiliation":[{"name":"Department of Cardiology Odense University Hospital  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mads J.","family":"Andersen","sequence":"additional","affiliation":[{"name":"The Heart Center Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Finn","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"The Heart Center Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Hassager","sequence":"additional","affiliation":[{"name":"The Heart Center Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob E.","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Cardiology Odense University Hospital  Odense 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