{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T12:22:12Z","timestamp":1790511732014,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,3,9]],"date-time":"2017-03-09T00:00:00Z","timestamp":1489017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Radboud Institute for Health Sciences"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2017,6,15]]},"abstract":"<jats:sec><jats:title>Key points<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Severe aortic valve diseases are common cardiac abnormalities that are associated with poor long\u2010term survival.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Before any reduction in left ventricular (LV) function, the left ventricle undergoes structural remodelling under the influence of changing haemodynamic conditions.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>In this study, we combined temporal changes in LV structure (volume) with alterations in LV functional characteristics (strain, \u0511) into a \u0511\u2013volume loop, in order to provide novel insight into the haemodynamic cardiac consequences of aortic valve diseases in those with preserved LV ejection fraction.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>We showed that our novel \u0511\u2013volume loop and the specific loop characteristics provide additional insight into the functional and mechanical haemodynamic consequences of severe aortic valve diseases (with preserved LV ejection fraction).<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Finally, we showed that the \u0511\u2013volume loop characteristics provide discriminative capacity compared with conventional measures of LV function.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>The purpose of this study was to examine left ventricular (LV) strain (\u0511)\u2013volume loops to provide novel insight into the haemodynamic cardiac consequences of aortic valve stenosis (AS) and aortic valve regurgitation (AR). Twenty\u2010seven participants were retrospectively recruited: AR (<jats:italic>n\u00a0=\u00a0<\/jats:italic>7), AS (<jats:italic>n\u00a0=\u00a0<\/jats:italic>10) and control subjects (<jats:italic>n\u00a0=\u00a0<\/jats:italic>10). Standard transthoracic echocardiography was used to obtain apical four\u2010chamber images to construct \u0511\u2013volume relationships, which were assessed using the following parameters: early systolic \u0511 (\u0511_ES); slope of \u0511\u2013volume relationship during systole (Sslope); end\u2010systolic peak \u0511 (peak \u0511); and diastolic uncoupling (systolic \u0511\u2013diastolic \u0511 at same volume) during early diastole (UNCOUP_ED) and late diastole (UNCOUP_LD). Receiver operating characteristic curves were used to determine the ability to detect impaired LV function. Although LV ejection fraction was comparable between groups, longitudinal peak \u0511 was reduced compared with control subjects. In contrast, \u0511_ES and Sslope were lower in both pathologies compared with control subejcts (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01), but also different between AS and AR (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). UNCOUP_ED and UNCOUP_LD were significantly higher in both patient groups compared with control subjects (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.05). Receiver operating characteristic curves revealed that loop characteristics (AUC\u00a0=\u00a00.99, 1.00 and 1.00; all <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01) were better able then peak \u0511 (AUC\u00a0=\u00a00.75, 0.89 and 0.76; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.06, &lt;0.01 and 0.08, respectively) and LV ejection fraction (AUC\u00a0=\u00a00.56, 0.69 and 0.69; all <jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.05) to distinguish AS <jats:italic>vs<\/jats:italic> control, AR <jats:italic>vs<\/jats:italic> control and AS <jats:italic>vs<\/jats:italic> AR groups, respectively. Temporal changes in \u0511\u2013volume characteristics provide novel insight into the haemodynamic cardiac impact of AS and AR. Contrary to traditional measures (i.e. ejection fraction, peak \u0511), these novel measures successfully distinguish between the haemodynamic cardiac impact of AS and AR.<\/jats:p><\/jats:sec>","DOI":"10.1113\/jp273526","type":"journal-article","created":{"date-parts":[[2017,1,24]],"date-time":"2017-01-24T12:59:39Z","timestamp":1485262779000},"page":"3961-3971","source":"Crossref","is-referenced-by-count":29,"title":["Exploratory assessment of left ventricular strain\u2013volume loops in severe aortic valve diseases"],"prefix":"10.1113","volume":"595","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2422-8336","authenticated-orcid":false,"given":"Hugo G.","family":"Hulshof","sequence":"first","affiliation":[{"name":"Radboud Institute for Health Sciences, Department of Physiology Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arie P.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Radboud Institute for Health Sciences Department of Cardiology, Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith P.","family":"George","sequence":"additional","affiliation":[{"name":"Research Institute for Sport and Exercise Sciences Liverpool John Moores University  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria T. 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