Pre- and postoperative left atrial and ventricular volumetric and deformation analyses in severe aortic regurgitation
| Autor: | Maria Eriksson, Kenneth Caidahl, Anders Franco-Cereceda, Per Eriksson, Jonas Jenner, Johan Petrini, Ali Ilami |
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| Rok vydání: | 2021 |
| Předmět: |
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty Transthoracic echocardiography Aortic Valve Insufficiency Left atrial strain Diastole Volume overload Regurgitation (circulation) Thoracic aortic aneurysm Ventricular Function Left Ventricular Dysfunction Left Aortic valve replacement Left atrial Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Heart Atria cardiovascular diseases Left atrial function Retrospective Studies Angiology Heart Valve Prosthesis Implantation business.industry Research Ultrasound Stroke Volume General Medicine medicine.disease lcsh:RC666-701 Aortic Valve cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiovascular Ultrasound, Vol 19, Iss 1, Pp 1-10 (2021) Cardiovascular Ultrasound |
| ISSN: | 1476-7120 |
| DOI: | 10.1186/s12947-021-00243-4 |
| Popis: | Background The impact of volume overload due to aortic regurgitation (AR) on systolic and diastolic left ventricular (LV) indices and left atrial remodeling is unclear. We assessed the structural and functional effects of severe AR on LV and left atrium before and after aortic valve replacement. Methods Patients with severe AR scheduled for aortic valve replacement (n = 65) underwent two- and three-dimensional echocardiography, including left atrial strain imaging, before and 1 year after surgery. A control group was selected, and comprised patients undergoing surgery for thoracic aortic aneurysm without aortic valve replacement (n = 20). Logistic regression analysis was used to assess predictors of impaired left ventricular functional and structural recovery, defined as a composite variable of diastolic dysfunction grade ≥ 2, EF Results Diastolic dysfunction was present in 32% of patients with AR at baseline. Diastolic LV function indices and left atrial strain improved, and both left atrial and LV volumes decreased in the AR group following aortic valve replacement. Preoperative left atrial strain during the conduit phase added to left ventricular end-systolic volume index for the prediction of impaired LV functional and structural recovery after aortic valve replacement (model p p = 0.006). Conclusions One-third of patients with severe AR had signs of diastolic dysfunction. Aortic valve surgery reduced LV and left atrial volumes and improved diastolic indices. Left atrial strain during the conduit phase added to the well-established left ventricular end-diastolic dimension for the prediction of impaired left ventricular functional and structural recovery at follow-up. However, long-term follow-up studies with hard endpoints are needed to assess the value of left atrial strain as predictor of myocardial recovery in aortic regurgitation. |
| Databáze: | OpenAIRE |
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