Acute regional improvement of myocardial function after interventional transfemoral aortic valve replacement in aortic stenosis: A speckle tracking echocardiography study

Cardiovascular Ultrasound

Research

Kun Zhang¹  Verena Stangl¹  Fabian Knebel¹  Michael Laule¹  Karl Stangl¹  Wasiem Sanad¹  Sebastian Spethmann¹  Gert Baumann¹  Gerd Baldenhofer¹  Sebastian Schattke²  Ines Prauka³  Adrian C Borges⁴ 

[1] Charité - Universitätsmedizin Berlin, Medizinische Klinik m.S. Kardiologie und Angiologie, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany;Charité - Universitätsmedizin Berlin, Medizinische Klinik m.S. Kardiologie und Angiologie, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany;Klinik für Innere Medizin I, Kardiologie und Diabetologie, Helios Klinikum Emil von Behring Berlin, Walterhöferstraße 11, 14165, Berlin, Germany;Klinik am See, Abteilung für Kardiologie, Seebad 84, 15562, Rüdersdorf, Germany;Klinik für Innere Medizin I, Kardiologie und Diabetologie, Helios Klinikum Emil von Behring Berlin, Walterhöferstraße 11, 14165, Berlin, Germany;

关键词: Aortic Valve;    Aortic Stenosis;    Transcatheter Aortic Valve Implantation;    Circumferential Strain;    Aortic Valve Stenosis;   

DOI  :  10.1186/1476-7120-10-15

 received in 2011-12-14, accepted in 2012-03-26,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundTranscatheter aortic valve implantation (TAVI) is a promising therapy for patients with severe aortic stenosis (AS) and high perioperative risk. New echocardiographic methods, including 2D Strain analysis, allow the more accurate measurement of left ventricular (LV) systolic function. The goal of this study was to describe the course of LV reverse remodelling immediately after TAVI in a broad spectrum of patients with symptomatic severe aortic valve stenosis.MethodsThirty consecutive patients with symptomatic aortic valve stenosis and preserved LVEF underwent transfemoral aortic valve implantation. We performed echocardiography at baseline and one week after TAVI. Echocardiography included standard 2D and Doppler analysis of global systolic and diastolic function as well as 2D Strain measurements of longitudinal, radial and circumferential LV motion and Tissue Doppler echocardiography.ResultsThe baseline biplane LVEF was 57 ± 8.2%, the mean pressure gradient was 46.8 ± 17.2 mmHg and the mean valve area was 0.73 ± 0.27 cm2. The average global longitudinal 2D strain of the left ventricle improved significantly from -15.1 (± 3.0) to -17.5 (± 2.4) % (p < .001). This was reflected mainly in improvement in the basal and medial segments while strain in the apex did not change significantly [-11.6 (± 5.2) % to -15.1 (± 5.5) % (p < .001), -13.9 (± 5.1) % to -16.8 (± 5.6) % (p < .001) and -19.2 (± 7.0) % to -20.0 (± 7.2) % (p = .481) respectively]. While circumferential strain [-18.1 (± 5.1) % vs. -18.9 (± 4.2) %, p = .607], radial strain [36.5 (± 13.7) % vs. 39.7 (± 17.2) %, p = .458] and the LVEF remained unchanged after one week [57.0 (± 8.2) % vs. 59.1 (± 8.1) %, p = .116].ConclusionThere is an acute improvement of myocardial longitudinal systolic function of the basal and medial segments measured by 2D Strain analysis immediately after TAVI. The radial, circumferential strain and LVEF does not change significantly in all patients acutely after TAVI. These data suggest that sensitive new echo methods can reliably detect early regional changes of myocardial function after TAVI before benefits in LVEF are detectable.

【 授权许可】

Unknown   
© Schattke et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.