Prosthesis-patient mismatch and left ventricle systolic strain in patients with severe degenerative aortic stenosis, who are undergoing surgical valve replacement
| Autor: | Edyta Płońska-Gościniak, Jerzy Chudek, Agnieszka Sikora-Puz, Marek A. Deja, Artur Chmiel, Tomasz Bochenek, Bartosz Lasota, Magdalena Mizia, Klaudia Gieszczyk-Strózik, Katarzyna Mizia-Stec |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Aortic valve medicine.medical_specialty medicine.medical_treatment Prosthesis Ventricular Function Left Valve replacement Aortic valve replacement Internal medicine Humans Medicine Aged Aged 80 and over Heart Valve Prosthesis Implantation Ejection fraction business.industry Aortic Valve Stenosis Middle Aged Prognosis medicine.disease Stenosis medicine.anatomical_structure Echocardiography Ventricle Aortic Valve Aortic valve stenosis Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Kardiologia Polska. 74:537-546 |
| ISSN: | 1897-4279 0022-9032 |
| DOI: | 10.5603/kp.a2015.0219 |
| Popis: | Background: Prosthesis-patient mismatch (PPM) is an independent predictor of post-operative mortality after aortic valve replacement (AVR), particularly when it is associated with a left ventricle (LV) dysfunction. Two-dimensional speckle-tracking echocardiography (2D-STE) could be useful in assessing LV function in patients with PPM. Aim: To evaluate the impact of PPM on myocardial multidirectional LV systolic strain in patients who are undergoing AVR for severe degenerative aortic stenosis (AS). Methods: Sixty-five patients (38 females, 27 males, age: 69.9 ± 9.1 years) with severe degenerative AS and preserved LV ejection fraction were enrolled into the study. Pre- and three-month postoperative 2D-STE was performed to assess LV peak systolic longitudinal strain (LV PSLS), circumferential strain, and LV rotation. The indexed prosthesis effective orifice area (iEOAprosth) was used to define PPM (≤ 0.65 cm2/m2), and it was used to distinguish the study groups: PPM (+) (n = 35) and PPM (–) (n = 30). Results: A significant association of LV PSLS and interaction in the groups [PPM (+) vs. PPM (–)] and intervention (before vs. after AVR; p = 0.019) was observed — the lowest value of LV PSLS was in the PPM (+) group (–14.9 ± 3.5%) after AVR. A significant difference in the mean delta (before/after AVR) values of LV PSLS (0.7 ± 3.1% vs. –1.2 ± 3.6%; p = 0.04) in the PPM (+) vs. the PPM (–) groups was found. LV PSLS correlated with iEOAprosth (r = –0.520, p < 0.001) that was obtained three months after AVR. Conclusions: The occurrence of PPM in patients undergoing AVR for severe degenerative AS was associated with reduced LV PSLS in a three-month observation. |
| Databáze: | OpenAIRE |
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