Long‐Term Outcome in Asymptomatic Patients with Severe Aortic Regurgitation, Normal Left Ventricular Ejection Fraction, and Severe Left Ventricular Dilatation

Enache, Roxana; Antonini‐Canterin, Francesco; Piazza, Rita; Popescu, Bogdan A.; Leiballi, Elisa; Marinigh, Ricarda; Andriani, Cristina; Pecoraro, Rosa; Ginghină, Carmen; Nicolosi, Gian Luigi

doi:10.1111/j.1540-8175.2010.01193.x

Cited by 11 publications

(13 citation statements)

References 26 publications

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“…Although the patients with severe AR and severe LV dilatation remain asymptomatic for a long time, 46 symptomatic AR and systolic LV dysfunction both have a poor prognoses 2,47–49 . The optimal timing of surgical treatment is significantly associated with reduced cardiovascular mortality rate.…”

Section: Discussionmentioning

confidence: 99%

Strain Value in the Assessment of Left Ventricular Function and Prediction of Heart Failure Markers in Aortic Regurgitation

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Strain Value in the Assessment of Left Ventricular Function and Prediction of Heart Failure Markers in Aortic Regurgitation

et al. 2011

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“…However, the guidelines degree of LV dilation [LV end-diastolic diameter [70 mm or LV end-systolic diameter [50 mm or LV end-systolic diameter indexed to body surface area (BSA) [25 mm/m 2 ] and LV systolic dysfunction (LVEF \50 %) occurs in advanced AR stages. On the other hand, the influence of severe LV dilation on the progression of LV enlargement/hypertrophy and outcomes in asymptomatic AR patients with normal LVEF is not clearly established [5]. Also, LV linear dimensions do not properly reveal the three-dimensional LV geometry.…”

Section: Introductionmentioning

confidence: 93%

Left ventricular shape and mass impact torsional dynamics in asymptomatic patients with chronic aortic regurgitation and normal left ventricular ejection fraction

Enache

Popescu

Piazza

et al. 2015

Int J Cardiovasc Imaging

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Chronic aortic regurgitation (AR) is associated with a unique pattern of left ventricular (LV) volume and pressure overload, leading to LV remodelling. LV torsional motion, a key component of LV performance, can be altered in this setting. We aimed to assess the impact of LV remodelling on LV torsional dynamics parameters using speckle-tracking echocardiography (STE) in asymptomatic AR patients. We prospectively enrolled 60 patients with chronic AR and LVEF > 50% and 55 healthy controls. LV rotation, twisting and untwisting were assessed using STE. Patients with AR had higher LV diameters, volumes and mass, a more spherical LV shape than controls, but similar LVEF. In AR patients we found reduced peak LV apical rotation and decreased (2.1 ± 0.8 vs 2.9 ± 0.9°/cm, p < 0.001) and delayed (time to peak LV twist: 0.94 ± 0.12 vs 0.99 ± 0.09, p = 0.004) peak LV torsion. Also, peak LV untwisting velocity was decreased (-123.5 ± 41.5 vs -152.3 ± 55.0°/s, p = 0.002) due to lower peak LV apical diastolic rotation rate. LV shape influenced LV torsional dynamics, a more spherical LV displaying reduced peak LV apical rotation and diastolic rotation rate and decreased LV twist. A more hypertrophied LV had a lower peak LV torsion, peak LV apical diastolic rotation rate and peak LV untwisting velocity. LV apical rotation and torsion are decreased and LV twist is delayed in patients with chronic AR and normal LVEF, detecting early subclinical LV dysfunction before LVEF declines. Also, LV untwisting is reduced in these patients. LV remodelling impairs LV torsional dynamics parameters in this setting.

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“…But there is no cut-off value of LVEDD that can be used as an indicator of surgery 6,7. LV ejection fraction has also been widely studied to detect post-op LV dysfunction, but pre-op EF did not correlate with post-op EF 8-10.…”

Section: Introductionmentioning

confidence: 99%

Frequency of early remodeling of left ventricle and its comparison between patients with stroke volume >97 Ml versus patients with stroke volume <97 Ml after aortic valve replacement for severe aortic regurgitation

Rizvi¹,

Khalid²,

Baksh³

et al. 2016

Pak J Med Sci

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Objectives:To evaluate the frequency of early remodeling in patients of severe aortic regurgitation after aortic valve replacement and to see the incidence of early remodeling in patients with stroke volume >97 ml versus < 97 ml before aortic valve replacement.Method:This was a prospective comparative study conducted from August 2013 to December 2014 in a tertiary care hospital. Fifty seven (57) patients of isolated chronic aortic regurgitation were included in this study. SPSS v23 was used for data analysis. Independent sample t-test was used for analysis of continuous variables and chi-square test for qualitative variables.Results:Out of fifty seven patients, early remodeling occurred in 34 (59.64%) patients after surgery. The mean pre-operative stroke volume of patient in whom remodeling occurred was 110.3+9.66 ml while mean pre-operative stroke volume of patients who did not undergo remodeling was 86.65+7.63 ml. There were 28 (82.4%) patients with stroke volume >97 ml in whom Remodeling occurred where as in patients with stroke volume <97 ml remodeling occurred only in 6 (17.6%) patients (p value 0.004). There was no in-hospital mortality.Conclusion:There is an association between stroke volume and early LV remodeling after Aortic valve replacement. Stroke volume >97 ml is a good predictor of early LV remodeling.

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Long‐Term Outcome in Asymptomatic Patients with Severe Aortic Regurgitation, Normal Left Ventricular Ejection Fraction, and Severe Left Ventricular Dilatation

Cited by 11 publications

References 26 publications

Strain Value in the Assessment of Left Ventricular Function and Prediction of Heart Failure Markers in Aortic Regurgitation

Strain Value in the Assessment of Left Ventricular Function and Prediction of Heart Failure Markers in Aortic Regurgitation

Left ventricular shape and mass impact torsional dynamics in asymptomatic patients with chronic aortic regurgitation and normal left ventricular ejection fraction

Frequency of early remodeling of left ventricle and its comparison between patients with stroke volume >97 Ml versus patients with stroke volume <97 Ml after aortic valve replacement for severe aortic regurgitation

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