Impact of transcatheter aortic valve implantation on mechanical dispersion

Klæboe, Lars Gunnar; Brekke, P.; Aaberge, Lars; Haugaa, Kristina H.; Edvardsen, Thor

doi:10.1136/openhrt-2019-001199

Cited by 6 publications

(2 citation statements)

References 27 publications

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“…There was also excellent inter‐observer and intra‐observer reproducibility across all three vendors which is in keeping with reported intra‐class correlation values in previous LVMD studies 5,17–19 …”

Section: Discussionsupporting

confidence: 88%

Impact of inter‐vendor variability on evaluation of left ventricular mechanical dispersion

et al. 2021

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Purpose Left ventricular mechanical dispersion (LVMD) is a novel speckle tracking parameter for prognostic assessment of arrhythmic risk prediction. There is growing evidence to support its use in a variety of cardiomyopathic processes. There is paucity of data addressing any presence of inter‐vendor discrepancies for LVMD. The aim of this study was to assess inter‐vendor variability of LVMD in vendor specific software (VSS) and vendor independent software (VIS) in subjects with preserved and reduced left ventricular function. Methods Fifty‐nine subjects (14 normal subjects and 45 subjects with cardiac disease) were recruited and 2D speckle tracking echocardiographic images were acquired on two different ultrasound machines (GE and Philips). LVMD was measured by two different VSS (EchoPac GE and QLAB Philips) and one VIS (TomTec Arena). Results There was significant bias and wide limits of agreement (LOA) in the overall cohort observed between two different VSS (17.6 ms; LOA: ‐29.6 to 64.8; r: .47). There was acceptable bias and narrower LOA with good agreement for LVMD between images obtained on different vendors when performed on VIS (‐3.1 ms; LOA: ‐27.6 to 21.4; r: .75). QLAB LVMD was consistently higher than GE LVMD and TomTec LVMD in both preserved and reduced left ventricular function. LVMD measurements have high intra‐vendor reproducibility with excellent inter and intra‐observer agreement. Conclusions There was acceptable bias and narrower LOA for LVMD assessment on a VIS. Inter‐vendor variability exists for LVMD assessment between VSS. Serial measurements of LVMD should be performed using a single vendor for consistent and reliable results.

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Section: Discussionsupporting

confidence: 88%

Impact of inter‐vendor variability on evaluation of left ventricular mechanical dispersion

et al. 2021

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“…Its net effects on cardiac mechanics can be variable in different patients. Nevertheless, Klaeboe et al [57] further reported echo strain image study which showed a significant reduction in LV mechanical dispersion in TAVI patients without NO-LBBB. However, those with NO-LBBB after TAVI had actually worsened mechanical dispersion and were associated with a higher risk of mortality during a 22-month follow-up (HR 1.24).…”

Section: Effects Of Pacemaker and Bundle Branch Block On LV Remodelling And Outcomementioning

confidence: 97%

Challenges and opportunities in improving left ventricular remodelling and clinical outcome following surgical and trans-catheter aortic valve replacement

Jin

Petrou

et al. 2021

Front. Med.

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Over the last half century, surgical aortic valve replacement (SAVR) has evolved to offer a durable and efficient valve haemodynamically, with low procedural complications that allows favourable remodelling of left ventricular (LV) structure and function. The latter has become more challenging among elderly patients, particularly following trans-catheter aortic valve implantation (TAVI). Precise understanding of myocardial adaptation to pressure and volume overloading and its responses to valve surgery requires comprehensive assessments from aortic valve energy loss, valvular-vascular impedance to myocardial activation, force-velocity relationship, and myocardial strain. LV hypertrophy and myocardial fibrosis remains as the structural and morphological focus in this endeavour. Early intervention in asymptomatic aortic stenosis or regurgitation along with individualised management of hypertension and atrial fibrillation is likely to improve patient outcome. Physiological pacing via the His-Purkinje system for conduction abnormalities, further reduction in para-valvular aortic regurgitation along with therapy of angiotensin receptor blockade will improve patient outcome by facilitating hypertrophy regression, LV coordinate contraction, and global vascular function. TAVI leaflet thromboses require anticoagulation while impaired access to coronary ostia risks future TAVI-in-TAVI or coronary interventions. Until comparable long-term durability and the resolution of TAVI related complications become available, SAVR remains the first choice for lower risk younger patients.

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Changes and Prognostic Implications of Myocardial Work in Aortic Stenosis Subtypes Undergoing Transcatheter Valve Implantation

Pedersen,

Frederiksen,

Povlsen

et al. 2024

JACC: Advances

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Impact of transcatheter aortic valve implantation on mechanical dispersion

Cited by 6 publications

References 27 publications

Impact of inter‐vendor variability on evaluation of left ventricular mechanical dispersion

Impact of inter‐vendor variability on evaluation of left ventricular mechanical dispersion

Challenges and opportunities in improving left ventricular remodelling and clinical outcome following surgical and trans-catheter aortic valve replacement

Changes and Prognostic Implications of Myocardial Work in Aortic Stenosis Subtypes Undergoing Transcatheter Valve Implantation

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