Novel imaging insights into cardiac remodeling, myocardial function and risk stratification in cardiovascular disease

Abstract

In this thesis, novel and established imaging techniques have provided new insights into the pathophysiology and outcomes of various cardiac diseases.

In part I, a novel method of evaluating RV function is described and validated. Chapter 2 provides a proof of concept for the feasibility of RV myocardial work assessment on 2-dimensional speckle tracking strain echocardiography. This concept was validated in chapter 3 in a population with precapillary pulmonary hypertension.

Part II includes six chapters focused on novel insights into the risk stratification of patients with valvular heart disease. Chapter 4 demonstrates the differences and prognostic implications of LV remodeling in different types of bicuspid aortic valve disease, while chapter 5 shows the association between left atrial enlargement and outcome in patients with aortic regurgitation due to a bicuspid aortic valve. Chapter 6 evaluates the prevalence and prognostic relevance of mitral regurgitation in patients with a bicuspid aortic valve and chapter 7 investigates the importance of LV ejection fraction in patients with bicuspid aortic valve disease. Chapter 8 evaluates the mechanisms linking renal function and significant tricuspid regurgitation. Chapter 9 evaluates the prognostic role of the number of secondary outcome determinants on postsurgical survival in patients with degenerative mitral regurgitation.