scholarly journals Impact of valvuloarterial impedance on left ventricular longitudinal deformation in patients with aortic valve stenosis and preserved ejection fraction

2010 ◽  
Vol 103 (4) ◽  
pp. 227-235 ◽  
Author(s):  
Sylvestre Maréchaux ◽  
Émilie Carpentier ◽  
Marie Six-Carpentier ◽  
Philippe Asseman ◽  
Thierry H. LeJemtel ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Ejection Fraction ◽  
Aortic Valve Stenosis ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Longitudinal Deformation

scholarly journals Poster Session 3The imaging examination and quality assessmentP626Value of mitral and tricuspid annular displacement to assess the interventricular systolic relationship in severe aortic valve stenosis : a Pilot studyP627Follow-up echocardiography in asymptomatic valve disease: assessing the potential economic impact of the European and American guidelines in a dedicated valve clinic, compared to standard care.P628The tricuspid valve: identification of optimal view for assessing for prolapseP629Right atrial volume by two-dimensional echocardiography in healthy subjectsP630Disturbance of inter and intra atrial conduction assessed by tissue doppler imaging in patients with medicaly controlled hypertension and prehypertension.P631Liver stiffness by shear wave elastography, new noninvasive and quantitative tool for acute variation estimation of central venous pressure in real-time?P632Weak atrial kick contribution is associated with a risk for heart failure decompensationP633Usefulness of wave intensity analysis in predicting the response to cardiac resynchronization therapyP634Early subclinical left ventricular systolic and diastolic dysfunction in gestational hypertension and preeclampsiaP635Clinical comparison of three different echocardiographic methods for left ventricular ejection fraction and LV end diastolic volume measurementP636Assessment of right ventricular-arterial coupling parameters by 3D echocardiography in patients with pulmonary hypertension receiving specific vasodilator therapyP637Prediction of right ventricular failure after left ventricular assist device implant: assessing usefulness of standard and strain echocardiographyP638Kinematic analysis of diastolic function using the novel freely available software Echo E-waves - feasibility and reproducibilityP639Evaluation of coronary flow velocity by Doppler echocardiography in the treatment of hypertension with the ARB: correlation to the histological cardiac fibrosisP640The clinical significance of limited apical ischaemia and the prognostic value of stress echocardiography - A contemporary study from a high volume centerP641Effects of intermediate stenosis of left anterior descending coronary artery on survival in patients with chronic total occlusion of right coronary arteryP642Left ventricular remodeling after a first myocardial infarction in patients with preserved ejection fraction at dischargeP643Left atrial size and acute coronary syndromes. Let is make simple.P644Influence of STEMI reperfusion strategy on systolic and diastolic functionP645Aortic valve resistance risk-stratifies low-gradient severe aortic stenosisP646Does permanent pacemaker implantation complicate the prognosis of patients after transcatheter aortic valve implantation?P647Influence of metabolic syndrome and diabetes on progression of calcific aortic valve stenosis - The COFRASA - GENERAC StudyP648Low referral for aortic valve replacement accounts for worse long-term outcome in low versus high gradient severe aortic stenosis with preserved ejection fractionP649The impact of right ventricular function from aortic valve replacement: A randomised study comparing minimally invasive aortic valve surgery and conventional open heart surgery

2016 ◽  
Vol 17 (suppl 2) ◽  
pp. ii122.1-ii130
Author(s):  
T. Ota ◽  
DNS Senaratne ◽  
NK. Preston ◽  
F. Ferrara ◽  
D. Djikic ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Ejection Fraction ◽  
Aortic Valve Replacement ◽  
Right Ventricular ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Long Term Outcome

scholarly journals Higher Acceleration/Ejection Time Ratio Predicts Impaired Outcome in Aortic Valve Stenosis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Eigir Einarsen ◽  
Dana Cramariuc ◽  
Edda Bahlmann ◽  
Helga Midtbo ◽  
John B. Chambers ◽  
...  
Keyword(s):  
Heart Failure ◽  
Aortic Valve ◽  
Ejection Fraction ◽  
Aortic Valve Stenosis ◽  
Cardiovascular Death ◽  
Left Ventricular ◽  
Hazard Ratio ◽  
Left Ventricular Ejection ◽  
Heart Failure Hospitalization ◽  
Ejection Time

Background: Acceleration time (AT)/ejection time (ET) ratio is a marker of aortic valve stenosis (AS) severity and predicts outcome in moderate-severe AS. Methods: We explored the association of increased AT/ET ratio on prognosis in 1530 asymptomatic patients with presumably mild-moderate AS, normal ejection fraction, and without known diabetes or cardiovascular disease. Patients were part of the SEAS study (Simvastatin Ezetimibe Aortic Stenosis). Patients were grouped according to the optimal AT/ET ratio threshold to predict cardiovascular death and heart failure hospitalization. Low-gradient severe AS was identified as combined valve area ≤1.0 cm 2 and mean gradient <40 mm Hg. Outcome was assessed in Cox regression analyses, and results are reported as hazard ratio and 95% CI. Results: Higher AT/ET ratio was significantly associated with lower systolic blood pressure, lower left ventricular ejection fraction, lower stress-corrected midwall shortening, low flow, and with higher left ventricular mass and higher peak aortic jet velocity. AT/ET ratio ≥0.32 provided the optimal cutoff for predicting incident cardiovascular death and heart failure hospitalization in the total study sample. In patients with low-gradient severe AS, this threshold was >0.32. AT/ET ratio ≥0.32 had a 79% higher risk of cardiovascular death and heart failure hospitalization (hazard ratio, 1.79 [95% CI, 1.20–2.68]). In patients with low-gradient severe AS, AT/ET ratio >0.32 was associated with a 2-fold higher risk of cardiovascular death and heart failure hospitalization (hazard ratio, 2.15 [95% CI, 1.22–3.77]). Conclusions: In asymptomatic nonsevere AS and low-gradient severe AS, higher AT/ET ratio was associated with increased cardiovascular morbidity and mortality. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00092677.

P91 Prognostic value of tissue-tracking mitral annular displacement by speckle-tracking echocardiography in asymptomatic patients with aortic stenosis with preserved left ventricular ejection fraction

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
I Teraguchi ◽  
T Hozumi ◽  
H Emori ◽  
K Takemoto ◽  
N Maniwa ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Ejection Fraction ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Longitudinal Deformation ◽  
Cardiac Events ◽  
Tissue Tracking

Abstract Background   Management of asymptomatic severe aortic stenosis (AS) patients with preserved left ventricular (LV) ejection fraction (EF) remains controversial. Recent studies using have shown that decreased LV longitudinal deformation assessed by global longitudinal strain analysis can predict adverse cardiac events in AS patients with preserved EF. Tissue-tracking mitral annular displacement (TMAD) by speckle-tracking echocardiography provides rapid and simple assessment of LV longitudinal deformation even when the acoustic window is poor (Fig.1). Purpose  The purpose of this study was to examine the value of TMAD to predict occurrence of the cardiac events in asymptomatic severe AS patients with preserved EF. Methods   We studied 103 patients with severe AS and preserved EF [aortic velocity &gt;4m/s or aortic valve area (AVA) &lt;1.0 cm2, EF &gt;50%]in whom TMAD was measured, and a total of 44 patients were included in the final data setaccording to the exclusion criteria. Using TMAD analysis software, the base-to-apex displacement of automatically defined mid-point of mitral annular line in four-chamber view was quickly assessed, and the percentage of its displacement to LV length at end-diastole (%TMAD) was calculated (Fig.1). We investigated the association between %TMAD and the cardiac events including implementation of hospitalization due to heart failure, decreased EF (&lt; 50%), aortic valve replacement or transcatheter aortic valve implantation due to appearance of symptoms and cardiac death,  Results  In all the final study patients, %TMAD was successfully and quickly (within 10 seconds) evaluated. During a follow-up, the cardiac events developed in 16 (36%) of 44 patients. Tableshows echocardiographic parameters in patients with and without the cardiac events. %TMAD was significantly impaired in patients with the cardiac events compared with those without the cardiac events (9.6 ± 0.6 vs 12.1 ± 0.4%, p= 0.002). The other parameters were not involved in the event occurrence; age, LV mass index, EF, aortic velocity, AVA, tricuspid regurgitation pressure gradient (TR-PG), early diastolic /atrial filling velocity (E/A), early diastolic velocity of the mitral valve annulus (e’) and E/e’. In multiple variable analysis, %TMAD was an independentpredictor of the cardiac events (HR; 12.1, p= 0.001). ROC analysis revealed that the area under the curve of %TMAD was 0.81 for the cardiac events. Kaplan-Meier analysis showed %TMAD (cut-off: 11.9) provides a significant difference in the cardiac event (Fig. 2). Conclusions.  The present results suggests that TMAD easily and rapidly estimated by speckle-tracking echocardiography can be used as a simple method to predict occurrence of the cardiac events in asymptomatic severe AS patients with preserved EF. Abstract P91 Figure 1,2 and Table

scholarly journals Poster Session 5The imaging examination and quality assessmentP1064The natural course of heart failure with preserved ejection fraction (HFpEF) - insights from an exploratory echocardiographic registryP1065Epicardial fat and effectiveness of catheter radiofrequency ablation in patients with atrial fibrillation and metabolic syndromeP1066Systematic disinfection of echocardiographic probe after each examination to reduce the persistence of pathogens as a potential source of nosocomial infectionsP1067Left atrial mechanical function assessed by two-dimensional echocardiography in hypertensive patientsP1068Real live applications of three-dimensional echocardiographic quantification of the left ventricular volumes and function using an automated adaptive analytics algorithmP10693D echocardiographic left ventricular dyssynchrony indices in end stage kidney disease: associations and outcomesP1070Relative contribution of right ventricular longitudinal shortening and radial displacement to global pump function in healthy volunteersP1071ECHO-parameters, associated with short-term mortality and long-term complications in patients with pulmonary embolism of high and intermediate riskP1072Increased epicardial fat is an independent marker of heart failure with preserved ejection fraction.P1073Influence of optimized beta-blocker therapy on diastolic dysfunction determined echocardiographically in heart failure patientsP1074Early diastolic mitral flow velocity/ annular velocity ratio is a sensitive marker of elevated filling pressure in left ventricular dyssynchronyP1075Left ventricular diastolic function in STEMI patients receiving early and late reperfusion by percutaneous coronary intervention P1076Could anatomical and functional features predict cerebrovascular events in patients with patent foramen ovale?P1077Efficacy of endarterectomy of the left anterior descending artery: evaluation by adenosine echocardiography?P1078Left ventricular diastolic dysfunction after acute myocardial infarction with preserved ejection fraction is related to lower exercise capacityP1079Potentially predictors of ventricular arrhythmia during six months follow up in STEMI patientsP1080Association between left atrial dilatation and invasive haemodynamics at rest and during exercise in asymptimatic aortic stenosisP1081Cardiac amyloidosis and aortic stenosis - the convergence of two aging processes and its association with outcomesP1082Prognostic impact of initial left ventricular dysfunction and mean gradient after transcatheter aortic valve implantationP1083Distribution and prognostic significance of left ventricular global longitudinal strain in asymptomatic significant aortic stenosis: an individual participant data meta-analysisP1084Discrepancies between echocardiographic and invasive assessment of aortic stenosis in multimorbid elderly patientsP1085Echocardiographic determinants and outcome of patients with low-gradient moderate and severe aortic valve stenosis: implications for aortic valve replacementP1086Atrial deformation correlated with functional capacity in mitral stenosisP1087Net atrioventricular compliance can predict reduction of pulmonary artery pressure after percutaneous mitral balloon commissurotomy

2016 ◽  
Vol 17 (suppl 2) ◽  
pp. ii220.1-ii245 ◽  
Author(s):  
M. Koschutnik ◽  
VA. Ionin ◽  
S. Boeckstaens ◽  
L. Zakhama ◽  
R. Hinojar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Velocity Ratio ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Functional Features

P5987Novel model of intensity graded murine wire-induced aortic valve stenosis mimics distinct stages of human aortic valve pathology

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S T Niepmann ◽  
E Steffen ◽  
A Zietzer ◽  
M Adam ◽  
J Nordsiek ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Flow Velocity ◽  
Disease Progression ◽  
Aortic Regurgitation ◽  
Aortic Valve Stenosis ◽  
Left Ventricular ◽  
Valve Disease ◽  
Severe Injury

Abstract Background Aortic valve stenosis (AS) is the most common valve disease requiring therapeutic intervention. Even though the incidence of AS has been continuously rising and AS is associated with significant morbidity and mortality, to date, no medical treatments have been identified that can modify disease progression. In fact, only invasive interventional or surgical replacement of severely diseased valves is recommended. This unmet medical need is likely attributed to the lack of a clear understanding of the molecular mechanism driving disease development. To investigate the pathophysiology leading to AS, reliable and reproducible animal models that mimic human pathophysiology are needed. Hypothesis Induction of a graded wire-induced aortic valve stenosis model in mice is feasible to reflect and study pathophysiological mechanisms underlying the progression of aortic valve stenosis. Methods We have tested and expanded the protocols of a novel wire-injury induced aortic valve stenosis mouse model. A spring coronary guide wire or a bare metal wire was used to apply shear stress to the aortic valve cusps with increasing intensity with ultrasound-guided monitoring in male 10 to 12-week-old C57Bl/6j mice. These protocols allowed the induction of distinct models with soft, moderate and intense wire injury. Functional analysis including maximum flow velocity (Vmax), ejection fraction, fractional shortening, left ventricular volumes, diameters and wall thickness were assessed by echocardiography before, one and four weeks after induction of aortic valve stenosis. Immunohistological analysis were performed after eight weeks (hematoxylin and eosin, von-Kossa staining, anti-CD68-staining). Results Upon moderate or severe injury, AS developed with a significant increase in aortic valve peak blood flow velocity. While moderate injury promoted solitary AS, severe-injury induced mixed aortic valve disease with concomitant mild to moderate aortic regurgitation. Only 5% of the mice who received a moderate injury displayed a mild aortic regurgitation. In the group of mice with intense injury 50% of the mice had a mild and 18,75% had a moderate aortic insufficiency. The changes in aortic valve function were reflected by dilation and hypertrophy of the left ventricle, as well as a decreased left ventricular ejection fraction after intense injury, while moderate injury did not show significant dilation of the left ventricle. Histological analysis revealed the three classic hallmarks of human disease with aortic valve thickening, increased macrophage infiltration and calcification eight weeks after injury. Conclusion Hereby, we demonstrate that the induction of a graded wire induced aortic valve stenosis model in mice mimicking relevant pathophysiological mechanisms is feasible to study disease progression. We extended existing protocols to induce moderate stenosis allowing to solely study aortic valve stenosis without relevant aortic valve regurgitation. Acknowledgement/Funding S.N. was funded by Else-Kröner-Fresenius-Foundation of the Medical Faculty of the University of Bonn

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