La función sistólica longitudinal del ventrículo izquierdo, la poscarga y la contractilidad en la estenosis aórtica grave

Migliore, Ricardo A.; Adaniya, María E.; Barranco, Miguel Angel Molinero; González, Silvia; Miramont, Guillermo; Tamagusuku, Horacio

doi:10.7775/rac.es.v83.i4.5864

Cited by 3 publications

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“…Cioffi et al 25 studied 200 patients with asymptomatic AS with varying degrees of severity and found that the combination of circumferential (mFS < 16.5%) and longitudinal dysfunction (S wave < 8.5 cm/s) was 44% in patients with concentric hypertrophy, in addition to having higher diastolic dysfunction and lower AVA. In patients with LG/LFp, EF was not correlated with CL, as previously published 20,26 .…”

Section: Discussionsupporting

confidence: 75%

Assessment of left ventricular contractility in patients with severe aortic stenosis, low-flow, low-gradient and preserved ejection fraction

Migliore¹,

Adaniya²,

Barranco³

et al. 2022

ACME

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Introduction: In patients with severe aortic stenosis (AS), low-gradient, low-flow, and preserved ejection fraction (EF) (≥ 50%) (LG/LFp) the decrease in stroke volume index (Svi) could be due to diminished contractility. The aim of this study was to analyze if low Svi in patients withLG/LFp is related to a decrease in contractility. Methods: Thirty patients with LF/LGp and 63 normal subjects were studied with Doppler echocardiography. The level of contractility (LC) was assessed by mean of midwall shortening fraction (mSF) -end-systolic stress relationship. Relative wall thickness (RWT) and aortic valve area (AVA) were calculated. Results: LC was diminished in 40% of LF/LGp patients. By bivariate analysis LC correlated with RWT and mSF. Svi correlated with AVA but not with LC. In multiple linear regression, RWT and mSF were predictors independents of LC. About Svi, AVA was the only predictor independent variable. Conclusion: Decreased contractility was present in 40% of LF/LGp patients despite preserved EF. LC had correlation with mSF and EPR. Low Svi appears to be related to AS severity rather than low contractility.

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Section: Discussionsupporting

confidence: 75%

Assessment of left ventricular contractility in patients with severe aortic stenosis, low-flow, low-gradient and preserved ejection fraction

Migliore¹,

Adaniya²,

Barranco³

et al. 2022

ACME

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“…Cioffi, et al 25 estudiaron a 200 pacientes con EAo asintomática con diversos grados de gravedad y encontraron que la combinación de disfunción circunferencial (FAm < 16.5%) y longitudinal (onda S < 8.5 cm/s) fue de 44% en los pacientes con hipertrofia concéntrica, además de tener mayor disfunción diastólica y menor AVA. En los pacientes con GB/FBp, la FE no se correlacionó con el NC como ya se publicó con anterioridad 20,26 . Se ha comunicado que la depresión de la contractilidad es una posible causa de disminución del IVS y flujo aórtico en los pacientes con FB 27 .…”

Section: Discussionunclassified

Evaluación de la contractilidad del ventrículo izquierdo en pacientes con estenosis aórtica grave, flujo bajo, gradiente bajo y fracción de expulsión preservada

Migliore¹,

Adaniya²,

Barranco³

et al. 2021

ACM

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“…9,49 In fact, it has been shown that in patients with severe AS the longitudinal systolic function of the LV shows an inverse relationship with afterload. 32,50 In this aspect, Migliore et al 9 found that post-valvular factors play a substantial role in the pathophysiology of PLF AS, and emphasize the importance of routinely calculating the ratio of TSVI/Ao and Zva integrals. 7,9 Eco stress (with exercise or dobutamine at low doses)…”

Section: Other Parametersmentioning

confidence: 99%

Paradoxical aortic stenosis: much more than a classification problem

Fj¹

2018

JCCR

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Aortic stenosis (AS) is the most frequent valvular pathology and is one of the most common indications of valve replacement surgery. Its main form of presentation is calcified AS, whose prevalence increases proportionally with age. The indication of aortic valve replacement (AVR) is clear when the echocardiographic parameters of severity are coincident with each other and the patient presents symptoms, deterioration of the left ventricular ejection fraction (LVEF) or other indication of cardiac surgery. But with the advancement of diagnostic methods, new classifications of this condition have emerged. The term "paradoxical low-flow, low-gradient aortic stenosis" appears, which refers to the presence of an aortic valve area (AVA) <1 cm 2 or indexed AVA <0.6 cm 2 /m 2 , associated with low transvalvular flow and gradients, but with preserved LVEF (≥50%). This combination of data leads to a discordant classification (AVA in range of severity, medium gradient with values of mild to moderate disease). Due to the probability of potential errors that could underestimate the AVA by Doppler echo, and the uncertainty about the real meaning of this pathology, it is necessary to confirm the veracity of these findings, to give a correct diagnosis and treatment to patients with this intriguing entity.

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La función sistólica longitudinal del ventrículo izquierdo, la poscarga y la contractilidad en la estenosis aórtica grave

Cited by 3 publications

References 0 publications

Assessment of left ventricular contractility in patients with severe aortic stenosis, low-flow, low-gradient and preserved ejection fraction

Assessment of left ventricular contractility in patients with severe aortic stenosis, low-flow, low-gradient and preserved ejection fraction

Evaluación de la contractilidad del ventrículo izquierdo en pacientes con estenosis aórtica grave, flujo bajo, gradiente bajo y fracción de expulsión preservada

Paradoxical aortic stenosis: much more than a classification problem

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