Document Detail


Preoperative systolic strain rate predicts postoperative left ventricular dysfunction in patients with chronic aortic regurgitation.
MedLine Citation:
PMID:  20061517     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The best predictor for postoperative left ventricular (LV) systolic dysfunction in patients with chronic aortic regurgitation is still a matter of debate. The aim of this study was to assess the clinical significance of preoperative systolic radial strain rate (Ssr) derived from tissue Doppler echocardiography as a predictor of postoperative LV systolic dysfunction in patients with chronic aortic regurgitation. METHODS AND RESULTS: In 52 patients (mean age, 58 years; 13 women) with isolated chronic aortic regurgitation, we performed standard and tissue Doppler echocardiography before and after operation, obtained echocardiographic parameters such as LV dimensions and LV ejection fraction, and measured Ssr in 4 walls of the LV. Linear regression analysis determined correlations between preoperative parameters and postoperative LV ejection fraction. Receiver-operating characteristic curve analysis assessed the optimal cutoff values of parameters that predicted postoperative LV systolic dysfunction (ejection fraction <50%). The operation caused significant decreases in LV dimensions and volumes and significant increases in Ssr (1.94+/-0.64 to 2.39+/-0.83 per second; P<0.001) and ejection fraction (53.0+/-8.7 to 59.0+/-8.8%; P<0.001). Multiple regression analysis demonstrated that averaged Ssr was the only independent predictor of postoperative LV systolic dysfunction among the covariates examined (P<0.001). Using receiver-operating characteristic curve analysis, averaged Ssr yielded the greatest area under the curve among preoperative parameters (0.80) and was indicated to be a good predictor of postoperative LV dysfunction, with 90.9% sensitivity and 73.2% specificity (cutoff value, 1.82 per second). CONCLUSIONS: Measurement of preoperative averaged Ssr is useful in predicting postoperative LV systolic dysfunction and optimizing surgical timing in patients with isolated chronic aortic regurgitation.
Authors:
Tetsuari Onishi; Hiroya Kawai; Kazuhiro Tatsumi; Toshiya Kataoka; Daisuke Sugiyama; Hidekazu Tanaka; Yutaka Okita; Ken-ichi Hirata
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Publication Detail:
Type:  Journal Article     Date:  2010-01-08
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  3     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-17     Completed Date:  2010-05-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  134-41     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aortic Valve Insufficiency / physiopathology*,  surgery,  ultrasonography*
Case-Control Studies
Chronic Disease
Echocardiography, Doppler*
Female
Humans
Linear Models
Male
Middle Aged
Predictive Value of Tests
Preoperative Care
ROC Curve
Reproducibility of Results
Statistics, Nonparametric
Systole
Ventricular Dysfunction, Left / etiology,  physiopathology*,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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