Measures of right ventricular function after transcatheter versus surgical aortic valve replacement
| Autor: | Nikolaj Ihlemann, Hans Gustav Hørsted Thyregod, Finn Gustafsson, Christian Hassager, Lars Søndergaard, Anh Thuc Ngo, Hanne Berg Ravn, Jesper Kjaergaard, Lars Grønlykke, J.C. Nilsson, André Korshin |
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| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve Male medicine.medical_specialty 030204 cardiovascular system & hematology Nyha class Ventricular Function Left Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Aortic valve replacement Internal medicine medicine Humans Systole Aged Aged 80 and over Ejection fraction Ventricular function business.industry Stroke Volume Aortic Valve Stenosis medicine.disease Stenosis medicine.anatomical_structure Treatment Outcome 030228 respiratory system Echocardiography Aortic valve stenosis Heart Valve Prosthesis Cardiology Ventricular Function Right Surgery Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Interactive cardiovascular and thoracic surgery. 24(2) |
| ISSN: | 1569-9285 |
| Popis: | Objectives Describe changes in measures of right ventricular (RV) function in patients treated for aortic stenosis using open-chest surgery (SAVR) or transcatheter treatment (TAVR). Methods Patients in the Nordic Aortic Valve Intervention (NOTION) trial were randomized 1:1 to TAVR (n = 114) or SAVR (n = 106). Echocardiography was performed at baseline and 3 and 12 months post-procedure. Tricuspid annular plane systolic excursion (TAPSE) and right ventricular fractional area change (RVFAC) were used as measures of longitudinal and transverse RV contraction. Left ventricular ejection fraction (LVEF) and LV atrioventricular plane displacement (AVPD) were recorded as measures of LV function. Association to NYHA class was examined. Results There were no differences in echocardiographic measurements between TAVR and SAVR at baseline. In the SAVR group, TAPSE was reduced after 3 months (2.4 ± 0.5 cm vs 1.6 ± 0.4 cm; P < 0.001), and 12 months (2.4 ± 0.5 cm vs 1.7 ± 0.4 cm; P < 0.001). RVFAC was reduced after 3 months (44% ± 11% vs 39% ± 10%; P = 0.001), but recovered at 12 months (43% ± 10%; P = 0.39). AVPD lateral increased during follow-up (1.4 ± 0.3 cm vs 1.6 ± 0.4 cm (P = 0.001) and 1.7 ± 0.4 cm, respectively; P < 0.001), whereas AVPD medial remained stable (baseline vs 3 months: P = 0.06 and baseline vs 12 months: P = 0.59). In the TAVR group, all echocardiographic measures remained unchanged from baseline to 12 months postoperatively. We found no association between echocardiographic changes and NYHA class. Conclusions TAPSE and AVPD lateral differed between TAVR and SAVR at 3 and 12 months follow-up, but these findings were not related to any changes in NYHA class. These observations indicate that following SAVR, echocardiographic changes may not reflect right ventricular function, but merely a change in the physiological conditions. Clinicaltrials.gov identifier NCT01057173. |
| Databáze: | OpenAIRE |
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