Twenty years after starting cardiac resynchronization therapy, do we understand the electromechanical coupling?

Donal, Erwan; Galli, Elena; Cosyns, Bernard

doi:10.1093/ehjci/jey152

Cited by 4 publications

(1 citation statement)

References 17 publications

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“…Previously, older age, lower LVEF, larger LV mass and AS severity have been associated with increasing mechanical dispersion in AS 11. Whether afterload influences heterogeneity of ventricular contractions, however, is subject to discussion 12. Transcatheter aortic valve implantation (TAVI) causes abrupt haemodynamic changes and provides an opportunity to explore whether significant afterload reduction influences mechanical dyssynchrony.…”

Section: Introductionmentioning

confidence: 99%

Impact of transcatheter aortic valve implantation on mechanical dispersion

et al. 2020

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ObjectivesThe physiological determinants of left ventricular (LV) mechanical dispersion (MD) are not fully explored. We aimed to investigate the impact of afterload reduction and changes in ventricular conduction on LV MD after transcatheter aortic valve implantation (TAVI).MethodsPatients with severe aortic stenosis (AS) were examined in a prospective, repeated measures observational cohort study before and after an uncomplicated transfemoral TAVI in a single tertiary centre. LV MD was assessed by speckle tracking echocardiography. Valvulo-arterial impedance (ZVA) was used as a measure of global afterload.ResultsWe included 140 consecutive patients (83±8 years old, 49% women, logistic EuroSCORE 16±10) with severe AS (valve area 0.7±0.2 cm2, mean transvalvular gradient 54±18 mm Hg) and a relatively preserved LV ejection fraction (52%±11%). After TAVI, we observed favourable changes in transvalvular gradients and ZVA in all patients. Compared with baseline, postprocedural MD was significantly lower in 108 patients with unchanged ventricular conduction (55±17 ms vs 51±17 ms, p=0.02) and higher in 28 patients with TAVI-induced left bundle branch block (51±13 ms vs 62±19 ms, p≤0.001). During 22±9 months observation, 22 patients died. Postprocedural MD was associated with mortality in a univariate Cox regression model (HR=1.24 (1.01–1.52), p<0.04, per 10 ms increase).ConclusionsIsolated afterload reduction was associated with reduction of MD, while concomitant impairment of ventricular conduction resulted in a more pronounced MD after TAVI, indicating that loading conditions and conduction should be considered when evaluating MD. A pronounced postprocedural LV MD was associated with mortality.

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Section: Introductionmentioning

confidence: 99%

Impact of transcatheter aortic valve implantation on mechanical dispersion

et al. 2020

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Septal flash is a prevalent and early dyssynchrony marker in transcatheter aortic valve replacement-induced left bundle branch block

Calle

Coeman

Desmet

et al. 2020

Int J Cardiovasc Imaging

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The year 2018 in the European Heart Journal—Cardiovascular Imaging: Part II

Cosyns

Haugaa

Gerber

et al. 2019

European Heart Journal - Cardiovascular Imaging

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European Heart Journal - Cardiovascular Imaging was launched in 2012 as a multimodality cardiovascular imaging journal. It has gained an impressive impact factor during its first 5 years and is now established as one of the top cardiovascular journals and has become the most important cardiovascular imaging journal in Europe. The most important studies from 2018 will be highlighted in two reports. Part I of the review has focused on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging, while Part II will focus on cardiomyopathies, congenital heart diseases, valvular heart diseases, and heart failure.

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Twenty years after starting cardiac resynchronization therapy, do we understand the electromechanical coupling?

Cited by 4 publications

References 17 publications

Impact of transcatheter aortic valve implantation on mechanical dispersion

Impact of transcatheter aortic valve implantation on mechanical dispersion

Septal flash is a prevalent and early dyssynchrony marker in transcatheter aortic valve replacement-induced left bundle branch block

The year 2018 in the European Heart Journal—Cardiovascular Imaging: Part II

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