Improvement in left ventricular function assessed by tissue Doppler imaging after aortic valve replacement for severe aortic stenosis

Nieh, Chih-Chiang; Teo, Alvin Kuo Jing; Soo, Wern Miin; Lee, Glenn K.; Singh, Devinder; Poh, Kian‐Keong

doi:10.11622/smedj.2015187

Cited by 4 publications

(5 citation statements)

References 30 publications

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“…Detection of subclinical systolic dysfunction often results in a poor prognosis and has been shown to improve after aortic valve replacement (15,27,28). Similarly, Nieh et al (29) found that echocardiographic parameters of patients operated for severe AS did not change LV diameter, mass and EF, but improvements in systolic and diastolic parameters measured by TDI were noted at a mean follow-up of 120 days. Subclinical systolic dysfunction detected by TDI has been shown in other valve pathologies and systemic diseases (30)(31)(32)(33)(34).…”

Section: Discussionmentioning

confidence: 94%

Evaluation of the Effect of Aortic Stenosis and Severity on Left Ventricular Function by Isovolumic Myocardial Acceleration

Akbay

Ertürk

Yazan

et al. 2020

Düzce Tıp Fakültesi Dergisi

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Aim: Tissue Doppler-derived isovolumic acceleration (IVA) is a parameter that evaluates the systolic function of both ventricles, without being affected by pre-load and post-load. We aimed to detect left ventricular systolic dysfunction at an early stage with IVA in patients with asymptomatic aortic stenosis (AS). Material and Methods: A total of 105 patients were included in the study, 75 of which had isolated AS and 30 were free of any valve disease. Patients with AS were divided into three groups (mild, moderate and severe) according to their aortic valve area (AVA) and aortic peak velocities, as determined by means of a transthoracic echocardiography. Conventional echocardiography, systolic and diastolic Tissue Doppler parameters [peak myocardial velocity during isovolumic contraction (IVV), myocardial velocity during ejection phase (Sm), early diastolic myocardial velocity (e'), late diastolic myocardial velocity (a'), and acceleration time (AT)] were calculated in all patients. IVA was obtained by dividing the IVV flow rate by the AT time. Results: The systolic parameters IVV (p<0.001), Sm (p<0.001), IVA (p=0.002) and diastolic parameters e' wave (p<0.001), a' wave (p=0.001) were found to be significantly lower in patients with AS compared to the control group. However, this relationship observed in IVA was not different in AS subgroups (p=0.122). Sm and e' waves were positively correlated with AVA (p=0.001, p<0.001, respectively) and negatively correlated with aortic peak gradient (p=0.008, p<0.001, respectively), but IVA was not correlated. Conclusion:Left ventricular function is impaired in patients with AS and this is independent of the severity of AS.

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Section: Discussionmentioning

confidence: 94%

Evaluation of the Effect of Aortic Stenosis and Severity on Left Ventricular Function by Isovolumic Myocardial Acceleration

Akbay

Ertürk

Yazan

et al. 2020

Düzce Tıp Fakültesi Dergisi

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“…In contrast to strain and SR, EF was less sensitive to significant changes in any of the procedures, but the mean values (except for TA-TAVR) indicated a tendency towards improvement. Changes in LV function after SAVR and TAVR have been the focus of several studies (17,(20)(21)(22)(23)(24)(25)(26). A review by Garg et al in 2017 summarized these changes with uniformly increasing longitudinal and circumferential strain, regional function, and twist, whereas EF was reported as either higher or unchanged (22).…”

Section: Systolic Functionmentioning

confidence: 99%

“…Several studies have shown the reversibility of hypertrophy and improvement of systolic function, as well as decreased filling pressures after both SAVR and TAVR (10)(11)(12)(13)(14)(15). In AS with preserved ejection fraction (EF), myocardial strain and peak systolic velocity (PSV) by tissue Doppler are highly sensitive markers of LV functional improvement after aortic valve replacement (AVR) (14)(15)(16)(17). In contrast, the right ventricular (RV) function and geometry are less affected by severe AS.…”

mentioning

confidence: 99%

Left and right ventricular functional changes after transapical, transfemoral, transcatheter, or surgical aortic valve replacement: A single-center observational study

Røsner

Kjønås

Malm

et al. 2022

Preprint

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Background: Decreasing right ventricular (RV) and left ventricular (LV) function after surgical or transcatheter aortic valve replacement (SAVR or TAVR, respectively) is an important risk factor for morbidity and mortality. Although transapical (TA)-TAVR is an independent risk factor for post-procedural mortality, limited knowledge is available regarding long-term changes in RV and LV function. The study aimed to evaluate LV and RV performance following four different AVR procedures, including TA-, transfemoral (TF)-TAVR, and SAVR with and without coronary artery bypass grafting (±CABG). Methods: Patients with severe AS were consecutively included and assigned to TA-TAVR, TF-TAVR, or SAVR ±CABG groups. A total of 130 patients underwent preoperative conventional and strain-rate-imaging echocardiography, with similar controls in the period between 6 and 12 months after the procedure. Results: After AVR, NYHA classes III and IV were reduced from 105 (81%) to 6 (5%) patients. While most of the systolic and diastolic functional parameters indicated improved LV function in the TF-TAVR and both SAVR groups, LV function did not significantly change after TA-TAVR. The right ventricular functional parameters were unchanged or even improved equally after TA-TAVR and TF-TAVR, while they were significantly reduced after SAVR. The Cardiac Index (CI) improved significantly after TF-TAVR from 2.3±0.7 to 2.6±0.7, while staying unchanged after TA-TAVR and SAVR±CABG. Conclusion: This study demonstrated significant changes in LV and RV systolic and diastolic function with functional improvement or deterioration depending on the type of aortic valve replacement. The most significant improvement in CI was observed after TF-TAVR, which is the least invasive procedure.

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“…For advanced features, mitral annular velocity (S') ≤ 4.5cm/s is linked to symptom onset, AVR need and cardiac death in patients with asymptomatic severe AS and preserved LVEF (67). Peak systolic mitral annular velocities improve early post TAVR and by 6 months after SAVR and TAVR (68,69). Other myocardial deformation parameters are impaired in AS and correlate with AS severity with reduced strain and strain rate predicting clinical events in asymptomatic AS (70).…”

Section: Left Ventricular Systolic Functionmentioning

confidence: 99%

Multimodality Imaging Markers of Adverse Myocardial Remodeling in Aortic Stenosis

Treibel

Badiani

Lloyd

et al. 2019

JACC: Cardiovascular Imaging

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Improvement in left ventricular function assessed by tissue Doppler imaging after aortic valve replacement for severe aortic stenosis

Cited by 4 publications

References 30 publications

Evaluation of the Effect of Aortic Stenosis and Severity on Left Ventricular Function by Isovolumic Myocardial Acceleration

Evaluation of the Effect of Aortic Stenosis and Severity on Left Ventricular Function by Isovolumic Myocardial Acceleration

Left and right ventricular functional changes after transapical, transfemoral, transcatheter, or surgical aortic valve replacement: A single-center observational study

Multimodality Imaging Markers of Adverse Myocardial Remodeling in Aortic Stenosis

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