| Valvuloarterial impedance does not improve risk stratification in low-ejection fraction, low-gradient aortic stenosis: results from a multicentre study. | |
| | |
MedLine Citation:
|
PMID: 21555457 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
OBJECTIVES: In a multicentre series of patients with low-ejection fraction/low-gradient aortic stenosis (LEF/LGAS), we evaluated the prognostic impact of valvuloarterial impedance (Zva). BACKGROUND: Zva in AS, a measure of global afterload taking into account systemic arterial compliance, has been proposed for risk stratification in paradoxical LGAS. We hypothesized that Zva could help risk stratification in LEF/LGAS. METHODS AND RESULTS: We retrospectively calculated Zva (5.6 ± 1.7 mmHg/mL/m(2)) of 184 consecutive patients (mean age: 71 ± 10 years) with severe symptomatic LEF/LGAS (valve area ≤1 cm², EF ≤40%, mean transaortic pressure gradient ≤40 mmHg) included between 1995 and 2005 in a multicentre registry. Zva was higher in patients with LVEF at rest ≤20% (6.6 ± 2.3 vs. 5.5 ± 1.6; P = 0.05) and correlated negatively with LVEF at rest (R = -0.25; P = 0.001). Zva was lower in patients without contractile reserve (CR) on dobutamine stress echocardiography (DSE) compared with patients with true severe AS (5.3 ± 1.3 vs. 5.8 ± 1.8 mmHg/mL/m(2); P = 0.048). Zva and the variation in stroke volume during DSE were positively correlated (P = 0.0001) but Zva did not allow distinction between true and pseudo-severe AS (5.8 ± 1.8 vs. 5.3 ± 1.8mmHg/mL/m(2); P = 0.30). In the total population, Zva was not predictive of long-term mortality. In the 128 patients who underwent aortic valve replacement, Zva was not predictive of operative death and of long-term mortality. CONCLUSIONS: Increased Zva is related to low LVEF and more frequent CR on DSE in LEF/LGAS. However, Zva did not allow an accurate distinction between true and pseudo-severe AS and failed to predict operative and long-term mortality after aortic valve replacement, in LEF/LGAS. |
| | |
Authors:
|
Franck Levy; Jean Luc Monin; Dan Rusinaru; Hélène Petit-Eisenmann; Claude Lelguen; Christophe Chauvel; Catherine Adams; Damien Metz; Francois Leleu; Pascal Gueret; Christophe Tribouilloy |
Related Documents
:
|
2873967 - A comparison of oral astemizole with topical sodium cromoglycate in the treatment of ha... 21435267 - Extended dosing of darbepoetin alfa in peritoneal dialysis patients. 21241427 - Liver resection in obese patients: results of a case-control study. 21507467 - Validation of postoperative nomograms in prostate cancer patients with long-term follow... 18264827 - Endoscopic evaluation of reflux esophagitis after proximal gastrectomy: comparison betw... 2742407 - Aortic reconstruction in high-risk pulmonary patients. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology Volume: 12 ISSN: 1532-2114 ISO Abbreviation: Eur J Echocardiogr Publication Date: 2011 May |
Date Detail:
|
Created Date: 2011-05-10 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100890618 Medline TA: Eur J Echocardiogr Country: England |
Other Details:
|
Languages: eng Pagination: 358-63 Citation Subset: IM |
Affiliation:
|
Department of Cardiology and INSERM and ERI-12, University Hospital, Amiens, France. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Recommendations of the European Association of Echocardiography How to use echo-Doppler in clinical ...
Next Document: Tuberous sclerosis complex and Myc coordinate the growth and division of Drosophila intestinal stem ...