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Right ventricular function in severe aortic stenosis assessed by echocardiography and MRI
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Thoracic and Vascular Surgery.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Thoracic and Vascular Surgery. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0003-4337-7900
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0002-5716-5098
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2024 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 44, no 3, p. 211-219Article in journal (Refereed) Published
Abstract [en]

Background: The prevalence of aortic valve stenosis (AS) is increasing due to an ageing population. Despite that right ventricular function has prognostic value for postoperative outcome, the right ventricle (RV) is not extensively studied and often not routinely assessed in AS. Our aim was to explore the relation between severe AS and RV function in a surgical aortic valve replacement (SAVR) cohort, comparing two imaging modalities for RV evaluation.Methods: Patients with severe AS, underwent cardiovascular magnetic resonance imaging (CMR) and transthoracic echocardiography (TTE) before SAVR. RV dysfunction was defined as one or more of the following: tricuspid annular plane systolic excursion (TAPSE) < 17 mm, RV free wall strain (RVFWS) > -20% by TTE and RV ejection fraction (RVEF) <50% by CMR.Results: Sixteen (33%) patients were found to have RV dysfunction. Patients with RV dysfunction showed significantly lower indexed aortic valve area, left ventricular (LV) ejection fraction as well as RV and LV stroke volumes compared to patients with maintained RV function. All patients with reduced RVEF also had changes in TAPSE or RVFWS and a larger number of patients had a reduced longitudinal RV function despite a normal RVEF.Conclusion: In a SAVR cohort one-third of the patients had RV dysfunction, defined by RVEF, TAPSE or RVFW strain. Echocardiography detected subtle changes in RV function before RVEF was reduced. It is likely that the more pronounced the AS, the more frequent the occurrence of RV dysfunction.

Place, publisher, year, edition, pages
WILEY , 2024. Vol. 44, no 3, p. 211-219
Keywords [en]
CMR; aortic valve replacement; heart function; imaging in aortic stenosis; valve disease
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:liu:diva-199539DOI: 10.1111/cpf.12867ISI: 001110006400001PubMedID: 37984438OAI: oai:DiVA.org:liu-199539DiVA, id: diva2:1818448
Note

Funding Agencies|ALF grant; Region Ostergotland and Linkoping University [RO-935260]; From student to docent, Region Ostergotland [RO-965090]

Available from: 2023-12-11 Created: 2023-12-11 Last updated: 2025-02-10Bibliographically approved

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Tamás, ÉvaNylander, EvaEngvall, JanGranfeldt, Hans

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Holmberg, EricaTamás, ÉvaNylander, EvaEngvall, JanGranfeldt, Hans
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Division of Diagnostics and Specialist MedicineFaculty of Medicine and Health SciencesDepartment of Thoracic and Vascular SurgeryCenter for Medical Image Science and Visualization (CMIV)Department of Clinical Physiology in Linköping
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Clinical Physiology and Functional Imaging
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