Reduced global longitudinal strain in association to increased left ventricular mass in patients with aortic valve stenosis and normal ejection fraction: a hybrid study combining echocardiography and magnetic resonance imaging

<p>Abstract</p> <p>Background</p> <p>Increased muscle mass index of the left ventricle (LVMi) is an independent predictor for the development of symptoms in patients with asymptomatic aortic stenosis (AS). While the onset of clinical symptoms and left ventricular systolic dysfunction determines a poor prognosis, the standard echocardiographic evaluation of LV dysfunction, only based on measurements of the LV ejection fraction (EF), may be insufficient for an early assessment of imminent heart failure. Contrary, 2-dimensional speckle tracking (2DS) seems to be superior in detecting subtle changes in myocardial function. The aim of the study was to assess these LV function deteriorations with global longitudinal strain (GLS) analysis and the relations to LVMi in patients with AS and normal EF.</p> <p>Methods</p> <p>50 patients with moderate to severe AS and 31 controls were enrolled. All patients underwent echocardiography, including 2DS imaging. LVMi measures were performed with magnetic resonance imaging in 38 patients with AS and indexed for body surface area.</p> <p>Results</p> <p>The total group of patients with AST showed a GLS of -15,2 ± 3,6% while the control group reached -19,5 ± 2,7% (p < 0,001). By splitting the group with AS in normal, moderate and severe increased LVMi, the GLS was -17,0 ± 2,6%, -13,2 ± 3,8% and -12,4 ± 2,9%, respectively (p = 0,001), where LVMi and GLS showed a significant correlation (r = 0,6, p < 0,001).</p> <p>Conclusions</p> <p>In conclusion, increased LVMi is reflected in abnormalities of GLS and the proportion of GLS impairment depends on the extent of LV hypertrophy. Therefore, simultaneous measurement of LVMi and GLS might be useful to identify patients at high risk for transition into heart failure who would benefit from aortic valve replacement irrespectively of LV EF.</p

Vibrational and Photoluminescence Properties of Composites Based on Double-Walled Carbon Nanotubes, Poly(o-phenylenediamine) and Poly(ethylene oxide)

Chemical polymerization of o-phenylenediamine (OPD) in the presence of poly(ethylene oxide), double-wall carbon nanotubes (DWNTs) and ferric chloride is carried out in order to obtain composites based on the poly(o-phenylenediamine)-poly(ethylene oxide) (POPD-PEO) fibres covered and interconnected with DWNTs. Vibrational and photoluminescence properties of these composite materials as well as their morphologies are shown by infrared (IR) spectroscopy, Raman scattering, photoluminescence (PL) and scanning electron microscopy (SEM). An adsorption of DWNTs onto the POPD rods surface in the absence and in the presence of PEO is highlighted by SEM. The vibrational changes reported by Raman scattering and IR spectroscopy prove a covalent functionalization of DWNTs with the macromolecular compound POPD which is doped with FeCl−4 ions. New hydrogen bonds are generated between POPD covalently functionalized DWNTs and hydroxyl groups of PEO according to IR spectroscopic studies. The two macromolecular compounds, POPD and POPD-PEO, show a complex emission band with maxima at 572 and 566 nm, having a shoulder at 667 nm. A significant change in the profile of the PL bands of POPD and POPD-PEO is induced in the DWNTs presence. We show that DWNTs induce (i) a diminution in the POPD PL band intensity peaked between 525–600 nm simultaneous with the increase in the intensity of the PL band situated in the 600–800 nm spectral range and (ii) an enhancement process of the emission band localized in the 475–800 nm spectral range in the case of POPD-PEO.</jats:p