Changes in mechanical dyssynchrony in severe aortic stenosis patients undergoing transcatheter aortic valve replacement
| Autor: | Brian Volz, Komal Safdar, Adam Magier, Wojciech Mazur, Vien T. Truong, Cheryl Bartone, Dean J. Kereiakes, Eugene S. Chung, John Broderick |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Heart Ventricles medicine.medical_treatment 030204 cardiovascular system & hematology Transcatheter Aortic Valve Replacement Ventricular Dysfunction Left 03 medical and health sciences QRS complex Basal (phylogenetics) 0302 clinical medicine Afterload Aortic valve replacement Valve replacement Internal medicine Humans Medicine Radiology Nuclear Medicine and imaging Sinus rhythm cardiovascular diseases 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over business.industry Aortic Valve Stenosis Middle Aged medicine.disease Stenosis Treatment Outcome medicine.anatomical_structure Echocardiography Ventricle Aortic Valve cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Echocardiography. 36:243-248 |
| ISSN: | 1540-8175 0742-2822 |
| DOI: | 10.1111/echo.14237 |
| Popis: | Introduction Aortic stenosis (AS) imposes a significant afterload on the left ventricle, but regional manifestations of the overall load may not be uniform, leading to mechanical dyssynchrony. Accordingly, we evaluated the prevalence of dyssynchrony in patients with severe AS at baseline as well as changes after transfemoral aortic valve replacement (TAVR). Methods This study is a retrospective analysis of 225 patients in sinus rhythm who underwent TAVR for severe AS, in whom inter-ventricular and intra-ventricular dyssynchrony were measured at baseline, discharge, 1 month, and 1 year. Inter-ventricular dyssynchrony was defined as the difference between left and right ventricular pre-ejection intervals; intra-ventricular dyssynchrony was defined as the difference between time to peak systolic velocity of the basal septal and lateral segments. Patients were further stratified into those with QRS 120 ms. Results At baseline, a quarter of patients met the criterion for significant inter-ventricular dyssynchrony, and a third had evidence of intra-ventricular dyssynchrony. Both decreased after TAVR although only the intra-ventricular dyssynchrony reached statistical significance. The interplay between QRS duration and changes in inter- and intra-ventricular dyssynchrony are also explored. Conclusions In patients with severe AS, there was evidence of mechanical dyssynchrony that is improved post-TAVR. Whether dyssynchrony is clinically and prognostically significant, and if it represents a potential target for additional therapy remains to be studied. |
| Databáze: | OpenAIRE |
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