scholarly journals 882 Left ventricular contractile reserve in severe aortic regurgitation: which kind of stress echo?

2003 ◽  
Vol 4 ◽  
pp. S111
Author(s):  
F MORI ◽  
F PIERI ◽  
A ODDO ◽  
G GALEOTA ◽  
A ZUPPIROLI
Keyword(s):  
Aortic Regurgitation ◽  
Left Ventricular ◽  
Contractile Reserve ◽  
Severe Aortic Regurgitation ◽  
Stress Echo

scholarly journals P329 Outcome prediction with force-based left ventricular contractile reserve during stress echocardiography

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D Morrone ◽  
A Zagatina ◽  
Q Ciampi ◽  
L Cortigiani ◽  
N Gaibazzi ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Hospital Admissions ◽  
Multivariable Analysis ◽  
Peak Stress ◽  
Regional Wall Motion ◽  
Left Ventricular ◽  
Contractile Reserve ◽  
Single Plane ◽  
Systolic Volume ◽  
Stress Echo

Abstract OnBehalf Stress Echo 2020 study group of the Italian Society of Cardiovascular Imaging Background Stress echo (SE) risk stratification is based on regional wall motion abnormalities (RWMA). The assessment of global left ventricular contractile reserve (LVCR) based on load-independent Force may refine prognosis. Aim To assess the value of LVCR during SE in predicting outcome Methods From September 2016 to December 2018, we prospectively enrolled 1848 patients (age 63 ± 11 years; 1121 males, 60%) with known or suspected coronary artery disease and/or heart failure evaluated with SE (exercise in 543, dipyridamole in 1184, adenosine in 10, dobutamine in 43) in 9 quality-controlled centers of 6 countries. Force was measured at rest and peak stress as the ratio of systolic blood pressure by cuff sphygmomanometer/end-systolic volume by 2D and biplane Simpson method of disks. When Simpson method was not feasible, apical single plane or linear parasternal methods were used to calculate volumes. Abnormal values of LVCR (peak/ rest) based on force were ≤1.10 for dipyridamole and adenosine; ≤1.61 for exercise or dobutamine. All patients were followed-up for a median of 16 months. Results RWMA and Force-based LVCR were obtained in all pts. Force was 4.24 ± 1.88 mmHg/ml at rest and increased during stress (7.07 ± 4.60 mmHg/ml, p<.001). At individual patient analysis, LVCR was abnormal in 495 (26%) and normal in 1373 (74%) patients. At follow-up, there were 218 events: 22 deaths, 22 non-fatal myocardial infarctions, 62 hospital admissions for acute heart failures, and 112 late (> 3 months from SE) myocardial revascularizations. At multivariable analysis, stress-induced RWMA (Hazard Ratio, HR, 2.899, 95% Confidence Intervals, CI: 2.032-4.137, p<.0.001), force-based LVCR (HR 1.747, 95% CI: 1.245-2.470, p=.002) were independent predictors. Kaplan-Meier curves showed worse event-free survival for pts with abnormal LVCR: see figure. Conclusion LVCR based on Force is a useful adjunct to RWMA for risk stratification with SE. Abstract P329 Figure. Survival curves and LVCR

scholarly journals New Imaging Markers of Clinical Outcome in Asymptomatic Patients with Severe Aortic Regurgitation

2019 ◽  
Vol 8 (10) ◽  
pp. 1654
Author(s):  
Radka Kočková ◽  
Hana Línková ◽  
Zuzana Hlubocká ◽  
Alena Pravečková ◽  
Andrea Polednová ◽  
...  
Keyword(s):  
Aortic Regurgitation ◽  
Early Stage ◽  
Laboratory Data ◽  
Left Ventricular ◽  
Vena Contracta ◽  
Severe Aortic Regurgitation ◽  
End Diastolic Volume ◽  
Asymptomatic Patients ◽  
Imaging Markers ◽  
And Function

Background: Determining the value of new imaging markers to predict aortic valve (AV) surgery in asymptomatic patients with severe aortic regurgitation (AR) in a prospective, observational, multicenter study. Methods: Consecutive patients with chronic severe AR were enrolled between 2015–2018. Baseline examination included echocardiography (ECHO) with 2- and 3-dimensional (2D and 3D) vena contracta area (VCA), and magnetic resonance imaging (MRI) with regurgitant volume (RV) and fraction (RF) analyzed in CoreLab. Results: The mean follow-up was 587 days (interquartile range (IQR) 296–901) in a total of 104 patients. Twenty patients underwent AV surgery. Baseline clinical and laboratory data did not differ between surgically and medically treated patients. Surgically treated patients had larger left ventricular (LV) dimension, end-diastolic volume (all p < 0.05), and the LV ejection fraction was similar. The surgical group showed higher prevalence of severe AR (70% vs. 40%, p = 0.02). Out of all imaging markers 3D VCA, MRI-derived RV and RF were identified as the strongest independent predictors of AV surgery (all p < 0.001). Conclusions: Parameters related to LV morphology and function showed moderate accuracy to identify patients in need of early AV surgery at the early stage of the disease. 3D ECHO-derived VCA and MRI-derived RV and RF showed high accuracy and excellent sensitivity to identify patients in need of early surgery.

Dimensional analysis of the left ventricle: effects of acute aortic regurgitation

1975 ◽  
Vol 228 (2) ◽  
pp. 536-542 ◽  
Author(s):  
SJ Leshin ◽  
LD Horwitz ◽  
JH Mitchell
Keyword(s):  
Left Ventricle ◽  
Aortic Regurgitation ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Systolic Volume ◽  
Severe Aortic Regurgitation ◽  
End Diastolic Volume ◽  
Catheter Technique ◽  
End Systolic Volume

The effects of acute severe aortic regurgitation on the left ventricle were investigated in conscious, chronically instrumented dogs. Left ventricular dimensions and volumes were measured from biplane cineradiographs of beads positioned near the endocardium. Data were collected before and after the production of aortic regurgitation by a catheter technique. The aortic regurgitation resulted in increases in mean aortic pulse pressure from 44 to 73 mmHg (P smaller than 0.001), heart rate from 87 to 122 beats/min (P smaller than 0.02), and left ventricular end-diastolic pressure from 11 to 25 mmHg (P smaller than 0.05). Mean end-diastolic volume rose from 61 to 69 cc (P smaller than 0.001), while end-systolic volume remained unchanged at 37 cc. The end-diastolic dilatation following regurgitation was asymmetrical in that the increase in size was due principally to an increase in the septal-lateral axis. The acute volume load of aortic regurgitation was accomplished by an increase in end-diastolic volume, i.e., the Frank-Starling mechanism. The tachycardia probably reflects augmented cardiac sympathetic activity, but the constant end-systolic volume at a similar mean systolic pressure suggests that the net contractile state was unchanged.

Left Ventricular Geometry in Takayasu Arteritis Complicated by Severe Aortic Regurgitation

Cardiology ◽  
1992 ◽  
Vol 80 (3-4) ◽  
pp. 180-183 ◽  
Author(s):  
Yuji Hashimoto ◽  
Fujio Numano ◽  
Toshiyuki Oniki ◽  
Shigeo Shimizu
Keyword(s):  
Aortic Regurgitation ◽  
Takayasu Arteritis ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Severe Aortic Regurgitation ◽  
Ventricular Geometry
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