{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T21:03:56Z","timestamp":1771967036641,"version":"3.50.1"},"reference-count":60,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004504","name":"Research Council of Lithuania","doi-asserted-by":"publisher","award":["09.3.3-LMT-K-712"],"award-info":[{"award-number":["09.3.3-LMT-K-712"]}],"id":[{"id":"10.13039\/501100004504","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: The presence of a relative apical sparing (RAS) echocardiographic strain pattern raises a suspicion of underlying cardiac amyloidosis (CA). However, it is also increasingly observed in patients with aortic stenosis (AS). We aimed to evaluate the prevalence, dynamics, and clinical characteristics of the RAS strain pattern in severe AS patients who had been referred for surgical aortic valve replacement (SAVR). Methods: A total of 77 patients with severe AS and without CA were included with a mean age of 70 (62\u201373) years, 58% female, a mean aortic valve area index of 0.45 \u00b1 0.1 cm2\/m2, and a mean gradient of 54.9 (45\u201370) mmHg. Results: An RAS strain pattern was detected in 14 (18%) patients. RAS-positive patients had a significantly higher LV mass index (125 \u00b1 28 g\/m2 vs. 91 \u00b1 32, p = 0.001), a lower LV ejection fraction (62 \u00b1 12 vs. 68 \u00b1 13, p = 0.040), and lower global longitudinal strain (\u201314.9 \u00b1 3 vs. \u201318.7 \u00b1 5%, p = 0.002). RAS strain pattern-positive patients also had higher B-type natriuretic peptide (409 (161\u2013961) vs. 119 (66\u2013245) pg\/L, p = 0.032) and high-sensitivity troponin I (15 (13\u201329) vs. 9 (5\u201318) pg\/L, p = 0.026) levels. Detection of an RAS strain pattern was strongly associated with increased LV mass index (OR 1.03, 95% CI 1.01\u20131.06, p &lt; 0.001). The RAS strain pattern had resolved in all patients by 3 months after SAVR. Conclusions: Our findings suggest that the RAS strain pattern can be present in patients with severe AS without evidence of CA. The presence of an RAS strain pattern is associated with adverse LV remodeling, and it resolves after SAVR.<\/jats:p>","DOI":"10.3390\/jpm14070707","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T11:33:53Z","timestamp":1719920033000},"page":"707","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Relative Apical Sparing Strain Pattern in Severe Aortic Valve Stenosis: A Marker of Adverse Cardiac Remodeling"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2865-1673","authenticated-orcid":false,"given":"Dovil\u0117","family":"Ramanauskait\u0117","sequence":"first","affiliation":[{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santari\u0161ki\u0173 Str. 2, LT-08410 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7447-3001","authenticated-orcid":false,"given":"Giedr\u0117","family":"Bal\u010di\u016bnait\u0117","sequence":"additional","affiliation":[{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santari\u0161ki\u0173 Str. 2, LT-08410 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darius","family":"Palionis","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Santari\u0161ki\u0173 Str. 2, LT-08410 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justinas","family":"Besusparis","sequence":"additional","affiliation":[{"name":"Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, P. Baublio Str. 5, LT-08406 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edvardas","family":"\u017durauskas","sequence":"additional","affiliation":[{"name":"Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, P. Baublio Str. 5, LT-08406 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8492-8428","authenticated-orcid":false,"given":"Vilius","family":"Janu\u0161auskas","sequence":"additional","affiliation":[{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santari\u0161ki\u0173 Str. 2, LT-08410 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4283-492X","authenticated-orcid":false,"given":"Aleksejus","family":"Zorinas","sequence":"additional","affiliation":[{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santari\u0161ki\u0173 Str. 2, LT-08410 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nomeda","family":"Valevi\u010dien\u0117","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Santari\u0161ki\u0173 Str. 2, LT-08410 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Sogaard","sequence":"additional","affiliation":[{"name":"Departament of Cardiology, Faculty of Medicine, Department of Clinical Medicine, Aalborg University Hospital, Hobrovej 18-22, 9100 Aalborg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5291-9954","authenticated-orcid":false,"given":"Sigita","family":"Glaveckait\u0117","sequence":"additional","affiliation":[{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santari\u0161ki\u0173 Str. 2, LT-08410 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1007\/s00259-010-1642-7","article-title":"Usefulness and Limitations of 99mTc-3,3-Diphosphono-1,2-Propanodicarboxylic Acid Scintigraphy in the Aetiological Diagnosis of Amyloidotic Cardiomyopathy","volume":"38","author":"Rapezzi","year":"2011","journal-title":"Eur. 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