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Characterization of myocardial mechanics and its prognostic significance in patients with severe aortic stenosis undergoing aortic valve replacement.
Bi, Xiaojun; Yeung, Darwin F; Thaden, Jeremy J; Nhola, Lara F; Schaff, Hartzell V; Pislaru, Sorin V; Pellikka, Patricia A; Pochettino, Alberto; Greason, Kevin L; Nkomo, Vuyisile T; Villarraga, Hector R.
Afiliación
  • Bi X; Department of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, Rochester, MN 55905, USA.
  • Yeung DF; Department of Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan City, Hubei Province 430030, PR China.
  • Thaden JJ; Department of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, Rochester, MN 55905, USA.
  • Nhola LF; Division of Cardiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada.
  • Schaff HV; Department of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, Rochester, MN 55905, USA.
  • Pislaru SV; Department of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, Rochester, MN 55905, USA.
  • Pellikka PA; Department of Cardiovascular Surgery, Mayo Clinic, 200 First St SW, Rochester, Rochester, MN 55905, USA.
  • Pochettino A; Department of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, Rochester, MN 55905, USA.
  • Greason KL; Department of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, Rochester, MN 55905, USA.
  • Nkomo VT; Department of Cardiovascular Surgery, Mayo Clinic, 200 First St SW, Rochester, Rochester, MN 55905, USA.
  • Villarraga HR; Department of Cardiovascular Surgery, Mayo Clinic, 200 First St SW, Rochester, Rochester, MN 55905, USA.
Eur Heart J Open ; 2(6): oeac074, 2022 Nov.
Article en En | MEDLINE | ID: mdl-36540107
Aims: Aortic stenosis (AS) induces characteristic changes in left ventricular (LV) mechanics that can be reversed after aortic valve replacement (AVR). We aimed to comprehensively characterize LV mechanics before and after AVR in patients with severe AS and identify predictors of short-term functional recovery and long-term survival. Methods and results: We prospectively performed comprehensive strain analysis by 2D speckle-tracking echocardiography in 88 patients with severe AS and LV ejection fraction ≥50% (mean age 71 ± 12 years, 42% female) prior to and within 7 days after AVR. Patients were followed for up to 5.2 years until death from any cause or last encounter. Within days after AVR, we observed an absolute increase in global longitudinal strain (GLS) (-16.0 ± 2.0% vs. -18.5 ± 2.1%, P<0.0001) and a decrease in apical rotation (10.5 ± 4.0° vs. 8.3 ± 2.8°, P = 0.0002) and peak systolic twist (18.2 ± 5.0° vs. 15.5 ± 3.8°, P = 0.0008). A baseline GLS is less negative than -16.2% was 90% sensitive and 67% specific in predicting a ≥ 20% relative increase in GLS. During a median follow-up of 3.8 years, a global circumferential systolic strain rate (GCSRs) less negative than -1.9% independently predicted lower survival. Conclusion: In patients with severe AS, a reversal in GLS, apical rotation, and peak systolic twist abnormalities towards normal occurs within days of AVR. Baseline GLS is the strongest predictor of GLS recovery but neither was associated with long-term survival. In contrast, abnormal baseline GCSRs are associated with worse outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Eur Heart J Open Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Eur Heart J Open Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido