| Valve replacement for aortic stenosis normalizes subendocardial function in patients with normal ejection fraction. | |
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MedLine Citation:
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PMID: 20219771 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Long-standing aortic stenosis (AS) causes various degrees of left ventricular (LV) dysfunction, which may improve after valve replacement. The aim of this study was to assess the nature of LV subendocardial abnormalities in AS and their response to valve replacement (AVR). METHODS AND RESULTS: We studied 41 consecutive symptomatic patients (age 64 +/- 13 years) with severe AS, normal LV ejection fraction (EF), but no obstructive coronary artery disease before, a week after AVR, and 6 months after AVR. LV subendocardial function was studied from recordings of long-axis M-mode (amplitude), tissue-Doppler (myocardial velocities) and speckle tracking (myocardial strain) echocardiographic techniques. Results were compared with those from 20 age- and gender-matched controls. In patients, LV dimensions and markers of asynchrony, total isovolumic time (t-IVT), and Tei index were not different from controls before AVR and remained unchanged afterwards. LV lateral long-axis amplitude, as well as lateral and septal systolic velocities and strain, were reduced (P < 0.001 for all) and E/E' was modestly raised. Lateral long-axis amplitude, systolic and diastolic velocities normalized within a week of AVR but strain lagged behind until 6 months later. The reduced septal long-axis amplitude remained permanently unchanged (NS) despite the early normalization of its systolic velocities (P < 0.001) and strain (P < 0.001). LV mass normalized at 6 months after AVR (P < 0.005). CONCLUSIONS: In patients with severe AS and maintained LV ejection fraction, subendocardial function is globally abnormal showing reduced amplitude of motion, velocities, and strain. The different response of its components suggests an evidence for differential reverse remodelling, irrespective of myocardial mass regression. |
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Authors:
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Per Lindqvist; Gani Bajraktari; Roberta Molle; Elizabetta Palmerini; Anders Holmgren; Sergio Mondillo; Michael Y Henein |
Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2010-03-10 |
Journal Detail:
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Title: European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology Volume: 11 ISSN: 1532-2114 ISO Abbreviation: Eur J Echocardiogr Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-06 Completed Date: 2010-12-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100890618 Medline TA: Eur J Echocardiogr Country: England |
Other Details:
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Languages: eng Pagination: 608-13 Citation Subset: IM |
Affiliation:
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Heart Centre, Umeå, Sweden. per.lindqvist@medicin.umu.se |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Aortic Valve* / surgery, ultrasonography Aortic Valve Stenosis / physiopathology, surgery*, ultrasonography* Case-Control Studies Echocardiography* Endocardium / ultrasonography* Female Heart Valve Prosthesis* Humans Italy Male Middle Aged Postoperative Care Predictive Value of Tests Preoperative Care Sensitivity and Specificity Severity of Illness Index Stroke Volume* Sweden Treatment Outcome Ventricular Function, Left* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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