Normalization of Diastolic Dysfunction in Aortic Stenosis Late After Valve Replacement

Villari, Bruno; Vassalli, Giuseppe; Es, Monrad; Chiariello, Massimo; Turina, Marko; Om, Hess

doi:10.1161/01.cir.91.9.2353

Cited by 210 publications

(146 citation statements)

References 23 publications

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“…Increase in E/A ratio is independently associated with reduction in diastolic BP, and finally, increase in mitral valve deceleration time is independently associated with decreased in mitral valve deceleration time. This corresponds well with what is found in dogs, 17 patients with aortic stenosis and aortic valve replacement, 29 and hypertensive patients without LV hypertrophy who had RWT regression. 16 Decrease in hemodynamic overload and remodeling of the myocardium have been associated with a decrease in muscle mass but a "relative" increase in fibrous tissue, which regresses less rapidly than myocardial tissue, necessitating 7 years for normalization of myocardial stiffness in one study.…”

Section: Discussionsupporting

confidence: 91%

Change in Diastolic Left Ventricular Filling After One Year of Antihypertensive Treatment

et al. 2002

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Background-It is well established that hypertensive patients with left ventricular (LV) hypertrophy have impaired diastolic filling. However, the impact of antihypertensive treatment and LV mass reduction on LV diastolic filling remains unclear. Methods and Results-Echocardiograms were recorded in 728 hypertensive patients with ECG-verified LV hypertrophy (Cornell voltage-duration or Sokolow-Lyon) at baseline and after 1 year of blinded treatment with either losartan or atenolol-based regimen. Systolic and diastolic blood pressures (BP) were reduced on average 23/11 mm Hg; isovolumic relaxation time and E/A ratio became more normal, and LV inflow deceleration time prolonged (all PϽ0.001).Directionally opposite changes in isovolumic relaxation time (IVRT) and deceleration time indicate improvement in active LV relaxation and passive chamber stiffness during early diastole. Prevalences of normal LV filling increased, abnormal relaxation and pseudonormalization decreased, and restrictive filling pattern remained unchanged (PϽ0.05).Patients with reduction in LV mass had smaller left atrial diameter, shortened IVRT, increased E/A ratio, and prolonged LV inflow deceleration time (all PϽ0.001). Patients without LV mass reduction had no change in diastolic filling parameters (PϭNS). IVRT shortening was independently associated with reduction in LV mass. Increase in E/A ratio was independently associated with reduction in diastolic BP, and increase in the deceleration time was independently associated with reduced end-systolic relative wall thickness. Conclusions-Antihypertensive therapy resulting in LV mass or relative wall thickness regression is associated with significant improvement of diastolic filling parameters related to active relaxation and passive chamber stiffness compared with patients without regression, independent of BP reduction; however, abnormalities of diastolic LV filling remain common.

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Section: Discussionsupporting

confidence: 91%

Change in Diastolic Left Ventricular Filling After One Year of Antihypertensive Treatment

et al. 2002

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“…resulting in progressive and continuous adverse remodeling, which soon improves following normalization of pressure overload 47,48) . Excess aldosterone secretion induces both pressure overload and hypervolemia via sodium retention and vasoconstriction and directly triggers the onset of cardiac fibrosis, possibly induced by various inflammatory reactions 7,49,50) .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cardiovascular Complications in Patients with and without <i>KCNJ5</i> Gene Mutations Harboring Aldosterone-producing Adenomas

Kitamoto

Suematsu

Matsuzawa

et al. 2015

J Atheroscler Thromb

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Aim: Our objective was to evaluate the incidence of cardiovascular complications before and after unilateral adrenalectomy in patients with and without KCNJ5 gene mutations harboring aldosterone-producing adenoma (APA). Methods: A total of 108 APA patients were evaluated in the present study. We compared the clinical characteristics and laboratory findings according to the cardiovascular complications in the patients with or without KCNJ5 gene mutations harboring APA after excluding five APA patients with ATPase or CACNA1D gene mutations. Conclusion:The present findings clearly demonstrated that KCNJ5 mutations are common among Japanese APA patients (frequency: 69.4%). In this study, the KCNJ5-mutated group demonstrated significant postoperative improvements in LVMI, possibly due to strong autonomous aldosterone production. Hence, it is necessary to precisely diagnose younger APA patients possessing a strong capacity for aldosterone production due to KCNJ5 gene mutations, as such cases may be easily complicated by cardiovascular events.

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“…After TAVI, almost complete normalization of LV afterload occurs without significant variability among patients [5,6]. Normalization of LV diastolic function [31] and benefit in ejection fraction, volumes, and hypertrophy are observed at long-term follow-up [32]. Gotzmann et al [33] have determined improvement in diastolic function at 6-month follow-up in patients undergoing TAVI with CoreValve prosthesis.…”

Section: Discussionmentioning

confidence: 99%

Immediate recovery of the left atrial and left ventricular diastolic function after transcatheter aortic valve implantation: A transesophageal echocardiography study

Sarı

Aslan²,

Baştuğ³

et al. 2016

Cardiol J.

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LV diastolic function was also explored by pulsed tissue Doppler imaging (TDI). Early (E') and late (A') diastolic annular velocities, E'/A' ratio and E/E' ratio were obtained. In addition, during the procedure before and minutes after the valve implantation, the left atrial appendage-peak antegrade flow velocity (LAA-PAFV) was measured and recorded with TEE.Results: Compared with baseline, the mean mitral E, septal E' and E'/A' ratio increased significantly after TAVI. In addition, the LAA-PAFV increased significantly within minutes of TAVI (32.45 ± 10.7 cm/s vs. 47.6 ± 12.6 cm/s, p < 0.001

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Normalization of Diastolic Dysfunction in Aortic Stenosis Late After Valve Replacement

Cited by 210 publications

References 23 publications

Change in Diastolic Left Ventricular Filling After One Year of Antihypertensive Treatment

Change in Diastolic Left Ventricular Filling After One Year of Antihypertensive Treatment

Comparison of Cardiovascular Complications in Patients with and without <i>KCNJ5</i> Gene Mutations Harboring Aldosterone-producing Adenomas

Immediate recovery of the left atrial and left ventricular diastolic function after transcatheter aortic valve implantation: A transesophageal echocardiography study

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