Significant Prognostic Value of Acute Preload Stress Echocardiography Using Leg-Positive Pressure Maneuver for Patients With Symptomatic Severe Aortic Stenosis Awaiting Aortic Valve Intervention
| Autor: | Hiroyuki Shimoura, Hiroki Matsuzoe, Keiko Ryo-Koriyama, Hiroyuki Sano, Ken-ichi Hirata, Hirotsugu Yamada, Yutaka Okita, Kensuke Matsumoto, Hidekazu Tanaka, Junichi Ooka, Toshiro Shinke, Yutaka Hatani, Keiko Hatazawa |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Aortic valve medicine.medical_specialty Positive pressure Diastole 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Internal medicine Ventricular Pressure medicine Stress Echocardiography Humans 030212 general & internal medicine Aged Aged 80 and over business.industry Aortic Valve Stenosis General Medicine Stroke volume Prognosis medicine.disease Stenosis Preload medicine.anatomical_structure Aortic Valve cardiovascular system Ventricular pressure Cardiology Female Cardiology and Cardiovascular Medicine business Echocardiography Stress |
| Zdroj: | Circulation Journal. 81:1927-1935 |
| ISSN: | 1347-4820 1346-9843 |
| DOI: | 10.1253/circj.cj-17-0143 |
| Popis: | BACKGROUND Although aortic valve intervention is recommended for virtually all symptomatic patients with aortic stenosis (AS), how urgently the intervention should be performed remains controversial. The aim of this study was thus to determine whether the preload reserve in response to leg-positive pressure (LPP) maneuver could serve for decision-making for AS patients awaiting aortic valve intervention.Methods and Results:Sixty-eight patients with symptomatic AS, who were referred for aortic valve intervention, were recruited. Stroke volume (SV) was assessed by means of pulsed-wave Doppler, and the ratio between transmitral E wave and mitral annular velocity (e') was calculated to estimate ventricular filling pressure. While waiting for intervention, 11 patients experienced preoperative cardiac events. During acute preload stress, forward SV for patients without cardiac events increased significantly (from 43±9 to 49±10 mL/m2, P |
| Databáze: | OpenAIRE |
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