Differential effects of afterload on left ventricular long- and short-axis function: Insights from a clinical model of patients with aortic valve stenosis undergoing aortic valve replacement

Carasso, Shemy; Cohen, Oved; Mutlak, Diab; Adler, Zvi; Lessick, Jonathan; Reisner, Shimon A.; Rakowski, Harry; Bolotin, Gil; Agmon, Yoram

doi:10.1016/j.ahj.2009.07.008

Cited by 79 publications

(66 citation statements)

References 21 publications

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“…Thus, localized abnormalities may interfere with longitudinal and circumferential function differentially. [35][36][37][38] Our results suggest that there is a potential mechanistic link among PTH control, LV mechanics, and LV mass. Hyperphosphatemia and hyperparathyroidism are established independent cardiovascular risk factors in ESRD.…”

Section: Discussionmentioning

confidence: 84%

Impact of Frequent Nocturnal Hemodialysis on Myocardial Mechanics and Cardiomyocyte Gene Expression

Chan

Arab

Carasso

et al. 2012

Circ: Cardiovascular Imaging

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Section: Discussionmentioning

confidence: 84%

Impact of Frequent Nocturnal Hemodialysis on Myocardial Mechanics and Cardiomyocyte Gene Expression

Chan

Arab

Carasso

et al. 2012

Circ: Cardiovascular Imaging

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“…8- 14 Carasso et al used speckle-tracking strain to demonstrate that longitudinal function was reduced in patients with severe AS and preserved EF and that it normalized after AVR. 8 Moreover, Lindqvist et al showed that longitudinal strain, assessed by means of tissue Doppler and speckle-tracking techniques, in patients with AS and preserved EF was significantly reduced, compared with age-and sex-matched normal controls, and that it improved after AVR. 13 In the same vein, Ng et al recently reported longitudinal, circumferential and radial speckle-tracking strain with an increase in AS severity in patients with AS and preserved EF.…”

Section: Longitudinal Myocardial Dysfunction In Patients With Asmentioning

confidence: 99%

Impact of Left Ventricular Afterload on Longitudinal Dyssynchrony in Patients With Severe Aortic Stenosis and Preserved Ejection Fraction

Yamawaki

Tanaka

Matsumoto

et al. 2012

Circ J

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“…The basal longitudinal motion is reduced, whereas apical circumferential motion increases [19,20]. The most striking effect after surgical and transcatheter AVR is increased basal longitudinal motion [21][22][23]. The apical region where the accelerometer was placed is less affected [18,21,24].…”

Section: Discussionmentioning

confidence: 87%

Detection of intraoperative myocardial dysfunction by accelerometer during aortic valve replacement

Grymyr

Beitnes

Eidet

et al. 2016

Interact CardioVasc Thorac Surg

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OBJECTIVES: Myocardial dysfunction may occur during weaning from cardiopulmonary bypass (CPB). Epicardial accelerometers have been shown to be useful in continuous monitoring of myocardial ischaemia during beating-heart surgery. We aimed to investigate whether an accelerometer can detect myocardial dysfunction during weaning from CPB. METHODS:In 23 patients undergoing isolated aortic valve replacement (AVR), a three-axis accelerometer was attached to the left ventricle and 3D velocity was calculated from the signals. Peak early systolic velocity (V sys ) and velocity at aortic valve closure (V avc ) were measured. Measurements were undertaken during normothermia with 50% bypass flow and atrial pacing (90 beats/min) before aortic cross-clamping and after cross-clamp removal. Myocardial dysfunction was defined as V sys < V avc , and patients were classified as having normal function or dysfunction. Left ventricular (LV) stroke work via pulmonary artery catheter and systolic velocity by echocardiography were compared between groups and used as reference methods. RESULTS:The accelerometer identified a substantial proportion of patients with myocardial dysfunction during weaning from CPB, 56% of patients compared with 11% before aortic cross-clamping. Patients classified with normal myocardial function during weaning significantly improved their LV stroke work and systolic velocity by echocardiography in response to AVR, whereas those classified with dysfunction did not. Accelerometer classification of normal function predicted an increase in echocardiographic systolic velocity [r = 0.63, regression coefficient 1.98, 95% CI (0.57, 3.40) (P < 0.01)]. CONCLUSIONS:The accelerometer detected myocardial dysfunction during weaning from CPB in accordance with measures obtained by echocardiography and pulmonary artery catheter.Clinical Trials identifier: NCT01926067. https://clinicaltrials.gov/.

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Differential effects of afterload on left ventricular long- and short-axis function: Insights from a clinical model of patients with aortic valve stenosis undergoing aortic valve replacement

Cited by 79 publications

References 21 publications

Impact of Frequent Nocturnal Hemodialysis on Myocardial Mechanics and Cardiomyocyte Gene Expression

Impact of Frequent Nocturnal Hemodialysis on Myocardial Mechanics and Cardiomyocyte Gene Expression

Impact of Left Ventricular Afterload on Longitudinal Dyssynchrony in Patients With Severe Aortic Stenosis and Preserved Ejection Fraction

Detection of intraoperative myocardial dysfunction by accelerometer during aortic valve replacement

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