Evolution of non-invasive myocardial work variables after transcatheter aortic valve implantation in patients with severe aortic stenosis - 15/04/23
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
Artículo gratuito.
Conéctese para beneficiarse!
Highlights |
• | Study of the effects of TAVI on myocardial function using myocardial work variables. |
• | Myocardial work indices can predict symptoms and postoperative LV systolic function. |
• | A prognostic study will have to confirm these promising results. |
Abstract |
Introduction |
Guidelines recommend aortic valve replacement in patients with severe aortic stenosis who present with symptoms or left ventricular ejection fraction<50%, both conditions representing a late stage of the disease. Whereas global longitudinal strain is load dependent, but interesting for assessing prognosis, myocardial work has emerged.
Aim |
To evaluate acute changes in myocardial work occurring in patients undergoing transcatheter aortic valve implantation (TAVI).
Methods |
Patients who underwent TAVI were evaluated before and after by echocardiography. Complete echocardiographies were considered. Myocardial work indices (global work index, global constructive work, global work efficiency, global wasted work) were calculated integrating mean transaortic pressure gradient and brachial cuff systolic pressure.
Results |
One hundred and twenty-five patients underwent successful TAVI, with a significant decrease in mean transaortic gradient (from 52.5±16.1 to 12.2±5.0; P<0.0001). There was no significant change in left ventricular ejection fraction after TAVI. Myocardial work data after TAVI showed a significant reduction in global work index (1389±537 vs. 2014±714; P<0.0001), global constructive work (1693±543 vs. 2379±761; P<0.0001) and global work efficiency (85.0±7.06 vs. 87.1±5.98; P=0.0034). The decrease in global work index and global constructive work after TAVI was homogeneous among different subgroups, based on global longitudinal strain, left ventricular ejection fraction and New York Heart Association status before TAVI. We observed a significant association between global work index and global constructive work before TAVI, and global longitudinal strain degradation after TAVI.
Conclusions |
Myocardial work variables show promising potential in best understanding the left ventricular myocardial consequences of aortic stenosis and its correction. Given their ability to discriminate between New York Heart Association status and global longitudinal strain evolution, we can hypothesize about their clinical value.
El texto completo de este artículo está disponible en PDF.Keywords : Aortic stenosis, Transcatheter aortic valve implantation, Myocardial work, Speckle tracking analysis
Esquema
Vol 116 - N° 4
P. 192-201 - avril 2023 Regresar al número
Artículo precedente
- Platelet activation and coronavirus disease 2019 mortality: Insights from coagulopathy, antiplatelet therapy and inflammation
- Aurélien Philippe, Richard Chocron, Guillaume Bonnet, Nader Yatim, Willy Sutter, Jérôme Hadjadj, Orianne Weizman, Coralie L. Guerin, Tristan Mirault, Charles Fauvel, Caroline Hauw-Berlemont, Charles-Marc Samama, Benjamin Terrier, Benjamin Planquette, Victor Waldmann, Michaela Fontenay, Olivier Sanchez, Jean-Luc Diehl, Pascale Gaussem, Ariel Cohen, Nicolas Gendron, David M. Smadja
- Correlation between three-dimensional echocardiography and cardiopulmonary fitness in patients with univentricular heart: A cross-sectional multicentre prospective study
- Valentin Femenia, Victor Pommier, Helena Huguet, Xavier Iriart, Marie-Christine Picot, Charlene Bredy, Laura Lorca, Gregoire De La Villeon, Sophie Guillaumont, Jean-Luc Pasquie, Stefan Matecki, François Roubertie, Bertrand Leobon, Jean-Benoît Thambo, Zakaria Jalal, Julie Thomas, Jean-Baptiste Mouton, Martina Avesani, Pascal Amedro
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.