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Preoperative Longitudinal Left Ventricular Function by Tissue Doppler Echocardiography at Rest and During Exercise Is Valuable in Timing of Aortic Valve Surgery in Male Aortic Regurgitation Patients
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
2010 (English)In: Journal of the American Society of Echocardiography, ISSN 0894-7317, E-ISSN 1097-6795, Vol. 23, no 4, 387-395 p.Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this study was to evaluate if left ventricular (LV) systolic function by tissue Doppler echocardiography at rest and during exercise preoperatively could predict postoperative LV function and thereby be useful in the timing of aortic valve surgery in patients with severe aortic regurgitation. Methods: In 29 patients (median age, 59 years; interquartile range, 39-64 years), echocardiography, tissue Doppler echocardiography, and radionuclide ventriculography were performed preoperatively and postoperatively at rest and during supine bicycle exercise. Results: Preoperative ejection fraction (EF) was 62%. Patients formed two groups, with basal LV peak systolic velocity (PSV) 5.9 cm/s preoperatively as the cutoff value between low and high PSV. Preoperatively, patients with low PSV had lower PSV during exercise (Pandlt;.005), EF during exercise (Pandlt;.05), and atrioventricular plane displacement (AVPD) at rest (Pandlt;.005) and during exercise (P andlt;.05) than those with high PSV. Postoperatively, patients with low PSV had smaller AVPD at rest (P andlt;.05), AVPD during exercise (Pandlt;.01), and PSV during exercise (Pandlt;.01). Conclusion: In patients with chronic aortic regurgitation with EFs and LV dimensions not fulfilling criteria for surgery according to guidelines, preoperative PSV and AVPD at rest and during exercise detected postoperative LV dysfunction.

Place, publisher, year, edition, pages
Elsevier Science B.V. Amsterdam , 2010. Vol. 23, no 4, 387-395 p.
Keyword [en]
Aortic valve insufficiency, Left ventricular function, Cardiac surgery, Tissue Doppler echocardiography, Exercise echocardiography
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-54856DOI: 10.1016/j.echo.2010.01.013ISI: 000276248600009OAI: oai:DiVA.org:liu-54856DiVA: diva2:310857
Note

Original Publication: Lena Helin, Eva Tamas and Eva Nylander, Preoperative Longitudinal Left Ventricular Function by Tissue Doppler Echocardiography at Rest and During Exercise Is Valuable in Timing of Aortic Valve Surgery in Male Aortic Regurgitation Patients, 2010, JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, (23), 4, 387-395. http://dx.doi.org/10.1016/j.echo.2010.01.013 Copyright: Elsevier Science B.V. Amsterdam http://www.elsevier.com/

Available from: 2010-04-16 Created: 2010-04-16 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Cardiac Function and Aortic Valve Intervention: Echocardiographic Studies of Myocardial Recovery in Patients with Severe Aortic Valve Disease
Open this publication in new window or tab >>Cardiac Function and Aortic Valve Intervention: Echocardiographic Studies of Myocardial Recovery in Patients with Severe Aortic Valve Disease
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In patients with severe aortic valve disease, aortic valve intervention is performed when the risk for mortality or morbidity with conservative management is significantly increased. Left ventricular (LV) longitudinal motion decreases before conventional echocardiographic measures such as ejection fraction, are influenced in patients with severe aortic valve disease. This thesis is devoted to the assessment of cardiac function, including ventricular longitudinal motion, by echocardiography before and after aortic valve intervention in patients with chronic severe aortic regurgitation (AR) or severe aortic stenosis (AS).

Patients with chronic AR (n=29) were studied preoperatively, and 6 months and 4 years postoperatively by echocardiography, including tissue Doppler imaging, at rest and during exercise. LV longitudinal function (atrioventricular plane displacement, AVPD, and peak systolic velocity, PSV) decreased postoperatively, and patients with low PSV continued to show reduced longitudinal function 6 months after surgery. Preoperative exercise echocardiographic variables showed a strong correlation to late LV function variables, while preoperative variables obtained at rest were not useful for prediction. Exercise echocardiography and longitudinal LV function could therefore be useful complements in the timing of aortic valve surgery for AR.

Patients with chronic AR (n=29) were studied preoperatively, and 6 months and 4 years postoperatively by echocardiography, including tissue Doppler imaging, at rest and during exercise. LV longitudinal function (atrioventricular plane displacement, AVPD, and peak systolic velocity, PSV) decreased postoperatively, and patients with low PSV continued to show reduced longitudinal function 6 months after surgery. Preoperative exercise echocardiographic variables showed a strong correlation to late LV function variables, while preoperative variables obtained at rest were not useful for prediction. Exercise echocardiography and longitudinal LV function could therefore be useful complements in the timing of aortic valve surgery for AR.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. 78 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1319
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-81051 (URN)978-91-7519-844-6 (ISBN)
Public defence
2012-09-28, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings Universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2012-09-06 Created: 2012-09-06 Last updated: 2012-09-06Bibliographically approved

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Helin Forsberg,, LenaTamas, EvaNylander, Eva

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