Light-chain (AL) amyloidosis is the most common type of systemic amyloidosis with poor prognosis. Currently, the predictors of cardiac involvement and prognostic staging systems are primarily based on conventional echocardiography and serological biomarkers. We used three-dimensional speckle tracking echocardiography (STE-3D) measurements of strain, hypothesizing that it could detect cardiac involvement and aid in prediction of mortality.

We retrospectively analysed 74 consecutive patients with biopsy-proven AL amyloidosis. Among them, 42 showed possible cardiac involvement and 32 without cardiac involvement. LV global longitudinal strain (GLS), global radial strain, global circumferential strain and global area strain (GAS) measurements were obtained.

The GLS and GAS were considered significant predictors of cardiac involvement. The cut-off values discriminating cardiac involvement were 16.10% for GLS, 32.95% for GAS. During the median follow-up of 12.5 months (interquartile range 4–25 months), 20 (27%) patients died. For the Cox proportional model survival analysis, heart rate, cardiac troponin T, NT-proBNP levels, E/e’, GLS, and GAS were univariate predictors of death. Multivariate Cox model showed that GLS ≤ 14.78% and cardiac troponin T ≥ 0.049 mg/l levels were independent predictors of survival.

STE-3D measurements of LV myocardial mechanics could detect cardiac involvement in patients with AL amyloidosis; GLS and cardiac biomarkers can provided prognostic information for mortality prediction.

• Biomarkers
• Cardiac amyloidosis
• Strain imaging
• Three-dimensional speckle tracking echocardiography

Three-dimensional (3D) left ventricular (LV) myocardial strain measurements using transthoracic 3D echocardiography speckle tracking analysis have several advantages over two-dimensional (2D) LV strain measurements, because 3D strain values are derived from the entire LV myocardium, yielding more accurate estimates of global and regional LV function. In this review article, we summarize the current status of 3D LV myocardial strain. Specifically, we describe how 3D LV strain analysis is performed. Next, we compare characteristics of 2D and 3D strain, and we explain validation of 3D strain measurements, feasibility and measurement differences between 2D and 3D strain, reference values of 3D strain, and its applications in several clinical scenarios. In some parts of this review, we used a meta-analysis to draw reliable conclusions. We also describe the added value of 3D over 2D strain in several specific pathologies and prognoses. Finally, we discuss novel techniques using 3D strain and suggest its future directions.

• 3D echocardiography
• Left ventricular strain
• Speckle tracking

Aortic valve stenosis in children is a congenital heart defect that causes fixed form of hemodynamically significant left ventricular outflow tract obstruction with progressive course. Neonates and young infants who have aortic valve stenosis, usually develop congestive heart failure. Children and adolescents who have aortic valve stenosis, are mostly asymptomatic, although they may carry a small but significant risk of sudden death. Transcatheter or surgical intervention is indicated for symptomatic patients or those with moderate to severe left ventricular outflow tract obstruction. Many may need reintervention.

• balloon aortic valvuloplasty
• congenital aortic stenosis
• congenital heart disease
• surgical aortic valvuloplasty

The bicuspid aortic valve, a kind of heart disease that comes from parents, has been paid attention around the world. Although most bicuspid aortic valve (BAV) patients will suffer from some complications including aortic stenosis, aortic regurgitation, endocarditis, and heart dysfunction in the late stage of the disease, there is none symptom in the childhood, which restrains us to diagnose and treatment in the onset phase of BAV. Hemodynamic abnormalities induced by the malformations of the valves in BAV patients for a long time will cause BAV-associated aortopathy: including progress aortic dilation, aneurysm, dissection and rupture, cardiac cyst and even sudden death. At present, preventive surgical intervention is the only effective method used in this situation and the diameter of the aorta is the primary reference criterion for surgery. And the treatment effects are always not satisfactory for patients and clinicians. Therefore, we need more methods to evaluate the progression of BAV and the surgery value and the appropriate intervention time by combining basic research with clinical treatment. In this review, advances in morphology, genetic, biomarkers, diagnosis and treatments are summarized, which expects to provide an update about BAV. It is our supreme expectations to provide some evidences for BAV early screening and diagnosis, and in our opinion, personalized surgical strategy is the trend of future BAV treatment.

• BAV
• aortopathy
• biomarker
• genetics
• morphology
• valvulopathy

• Aortic regurgitation
• Strain
• Three-dimensional speckle tracking
• Transcatheter aortic valve implantation

• Aged
• Aortic Valve/diagnostic imaging
• Aortic Valve/physiopathology
• Aortic Valve/surgery
• Aortic Valve Insufficiency/complications
• Aortic Valve Insufficiency/diagnostic imaging
• Aortic Valve Insufficiency/physiopathology
• Aortic Valve Insufficiency/surgery
• Biomechanical Phenomena
• Case-Control Studies
• Echocardiography, Three-Dimensional
• Female
• Humans
• Male
• Recovery of Function
• Risk Factors
• Stroke Volume
• Time Factors
• Transcatheter Aortic Valve Replacement/adverse effects
• Treatment Outcome
• Ventricular Dysfunction, Left/diagnostic imaging
• Ventricular Dysfunction, Left/etiology
• Ventricular Dysfunction, Left/physiopathology
• Ventricular Function, Left
• Ventricular Remodeling

• 3D echocardiography
• Aortic regurgitation
• Aortic stenosis
• Low flow low gradient aortic stenosis
• Speckle tracking echocardiography
• Strain
• Torsion
• Transcatheter aortic valve replacement

• Strain
• left ventricular function (LV function)
• myocardial deformation
• speckle-tracking
• three-dimensional strain (3D strain)

• ar
• valvular heart disease
• echocardiography