Layer-specific longitudinal strain detects transmural dysfunction in chronic severe aortic regurgitation before and after aortic valve surgery

2021 ◽  
Author(s):  
Frederik Fasth Grund ◽  
Charlotte Burup Kristensen ◽  
Hashmat Sayed Zohori Bahrami ◽  
Rasmus Mogelvang ◽  
Christian Hassager
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Longitudinal Strain ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Severe Aortic Regurgitation ◽  
Before And After

Echocardiographic Predictors of Left Ventricular Dysfunction after Aortic Valve Surgery in Children with Chronic Aortic Regurgitation

2012 ◽  
Vol 8 (4) ◽  
pp. 308-315 ◽  
Author(s):  
Elif Seda Selamet Tierney ◽  
Dana Gal ◽  
Kimberly Gauvreau ◽  
Jing Zhou ◽  
Yelda Soluk ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Chronic Aortic Regurgitation

scholarly journals 101 Quantifying aortic regurgitation with CMR can predict patients requiring aortic valve surgery

2008 ◽  
Vol 10 (S1) ◽  
Author(s):  
Saul G Myerson ◽  
Theodoros D Karamitsos ◽  
Jane M Francis ◽  
Adrian P Banning ◽  
Stefan Neubauer
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Valve Surgery ◽  
Aortic Valve Surgery

scholarly journals Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation

2019 ◽  
Vol 20 (10) ◽  
pp. 1105-1111
Author(s):  
E Mara Vollema ◽  
Gurpreet K Singh ◽  
Edgard A Prihadi ◽  
Madelien V Regeer ◽  
See Hooi Ewe ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
Time Course ◽  
Pressure Overload ◽  
Volume Overload ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Lv Mass

Abstract Aims Pressure overload in aortic stenosis (AS) and both pressure and volume overload in aortic regurgitation (AR) induce concentric and eccentric hypertrophy, respectively. These structural changes influence left ventricular (LV) mechanics, but little is known about the time course of LV remodelling and mechanics after aortic valve surgery (AVR) and its differences in AS vs. AR. The present study aimed to characterize the time course of LV mass index (LVMI) and LV mechanics [by LV global longitudinal strain (LV GLS)] after AVR in AS vs. AR. Methods and results Two hundred and eleven (61 ± 14 years, 61% male) patients with severe AS (63%) or AR (37%) undergoing surgical AVR with routine echocardiographic follow-up at 1, 2, and/or 5 years were evaluated. Before AVR, LVMI was larger in AR patients compared with AS. Both groups showed moderately impaired LV GLS, but preserved LV ejection fraction. After surgery, both groups showed LV mass regression, although a more pronounced decline was seen in AR patients. Improvement in LV GLS was observed in both groups, but characterized by an initial decline in AR patients while LV GLS in AS patients remained initially stable. Conclusion In severe AS and AR patients undergoing AVR, LV mass regression and changes in LV GLS are similar despite different LV remodelling before AVR. In AR, relief of volume overload led to reduction in LVMI and an initial decline in LV GLS. In contrast, relief of pressure overload in AS was characterized by a stable LV GLS and more sustained LV mass regression.

Left ventricular reverse remodeling after aortic valve surgery for acute versus chronic aortic regurgitation

2016 ◽  
Vol 33 (10) ◽  
pp. 1458-1464 ◽  
Author(s):  
Madelien V. Regeer ◽  
Michel I. M. Versteegh ◽  
Nina Ajmone Marsan ◽  
Martin J. Schalij ◽  
Robert J. M. Klautz ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Reverse Remodeling ◽  
Aortic Valve Surgery ◽  
Left Ventricular Reverse Remodeling ◽  
Chronic Aortic Regurgitation

scholarly journals 676 Impact of transcatheter aortic valve implantation in patients with severe aortic stenosis and concomitant mitral regurgitation

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Lina Manzi ◽  
Federica Ilardi ◽  
Fiorenzo Simonetti ◽  
Nicola Verde ◽  
Anna Franzone ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Longitudinal Strain ◽  
Severe Aortic Stenosis ◽  
Valve Surgery ◽  
Transcatheter Aortic Valve ◽  
Before And After ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Aims Severe aortic stenosis (AS) and functional mitral regurgitation (MR) frequently coexist. There is no consensus about the optimal therapeutic strategy for patients with combined valve disease. Evidence has shown that double valve surgery is associated with high complication rates and mortality, whereas MR severity may improve after transcatheter aortic valve implantation (TAVI). To date, little is known on prognostic parameters associated with MR improvement after TAVI. Recently, a new echocardiographic parameter based on the ratio between peak E velocity and peak atrial longitudinal strain (E/PALS) has demonstrated to be accurate and sensitive in the prediction of elevated filling pressure. Its role in the setting of AS patients undergoing TAVI has never been investigated. Our study aims to evaluate haemodynamic conditions and left ventricular (LV) systolic and diastolic function in patients with severe AS and concomitant MR undergoing TAVI and to identify new echocardiographic parameters associated with MR improvement 1 month after the aortic valve replacement. Methods We prospectively enrolled 87 consecutive patients (mean age 80 ± 6 years) with severe symptomatic AS and concomitant MR undergoing TAVI between 2016 and 2021, for whom a complete echocardiographic assessment was available at baseline and 1 month after the procedure, selected from the EffecTAVI registry. Exclusion criteria were prior valve surgery, severe mitral stenosis, permanent atrial fibrillation, and poor ultrasound acoustic window. Echo-Doppler assessment, including global longitudinal strain (GLS) and peak atrial longitudinal strain (PALS), was performed before and after 1 month to TAVI procedure. Changes (Δ) of the main echo parameters before and after intervention were computed. Results A month after the procedure, 20 (23%) patients had a reduction of at least one degree of MR (P <0.001). Dividing study population in two groups, based on whether or not MR was reduced after TAVI, we found that patients with MR improvement had higher LV end-diastolic volume (P = 0.036) and left atrial volume (P = 0.015) at baseline compared with those without MR reduction. After TAVI no significant differences were found in heart chambers size between the two groups, but a significant increase in PALS (23.2 ± 7.3 vs. 22.3 ± 7, P=0.028), together with a reduction in E/A ratio (0.69 ± 0.14 vs. 0.90 ± 0.46, P = 0.046) were detected in patients with MR reduction. Furthermore, Δ E/PALS (−17.3±34.4% vs. 3.9±35.0% P=0.027), Δ E/A (−12.6±33.9% vs. 24.7±64.3%, P=0.018) and Δ systolic pulmonary artery pressure (sPAP) (−13.0±20.2% vs. −2.0±18.3, P=0.031) were significantly higher in patients with MR improvement to compared those without MR reduction. By the multivariate logistic regression analysis performed in the pooled population, Δ E/PALS (OR 0.968, 95% CI: 0.947–0.990, P=0.005), together with LV mass at baseline (OR 1.056, 95% CI: 1.007–1.107, P = 0.024) appeared to be independently associated with MR reduction post-TAVI. Conclusions Our study demonstrated that: after TAVI in a significant percentage of patients a relevant improvement in concomitant MR was detected; in the group of patients with improved MR a parallel improvement of sPAP, E/A and E/PALS ratio post TAVI was found; Δ E/PALS appears to be the main parameter independently associated with the reduction of MR severity.

Sign in / Sign up

Export Citation Format

Share Document