Impact of Transcutaneous Aortic Valve Implantation on Myocardial Deformation

被引:14
作者
Grabskaya, Eva [1 ]
Becker, Michael [1 ]
Altiok, Ertunc [1 ]
Dohmen, Guido [2 ]
Brehmer, Kathrin [1 ]
Hamada-Langer, Sandra [1 ]
Kennes, Lieven [3 ]
Marx, Nikolaus [1 ]
Hoffmann, Rainer [1 ]
机构
[1] Univ Hosp RWTH Aachen, Med Clin 1, Aachen, Germany
[2] Univ Hosp RWTH Aachen, Dept Cardiac Surg, Aachen, Germany
[3] Univ Hosp RWTH Aachen, Dept Med Stat, Aachen, Germany
来源
ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES | 2011年 / 28卷 / 04期
关键词
aortic stenosis; echocardiography; valvular prothesis; STENOSIS; REPLACEMENT; TRACKING; STRAIN; ECHOCARDIOGRAPHY;
D O I
10.1111/j.1540-8175.2010.01378.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: To define the impact of transcutaneous aortic valve implantation (TAVI) using the CoreValve prosthesis on myocardial deformation in a serial echocardiographic study with analysis of strain and strain rate. Methods: In 36 patients (83 +/- 6 years; EuroScore: 26 +/- 13%) with severe aortic stenosis scheduled for CoreValve implantation serial echocardiographic studies pre- and postintervention (within 1 month) were performed. Midparasternal short-axis and three apical views were acquired. Using customized computer software which allows automatic frame-by-frame tracking of acoustic markers during the heart cycle circumferential, radial, and longitudinal strain (CS, RS, and LS) and strain rate (CSR, RSR, and LSR) were calculated for each segment in a 16 segment model of the left ventricle. Results: Longitudinal strain, systolic, and early diastolic longitudinal strain rate increased significantly within 1 month after TAVI (LS from -15.8 +/- 3.6% to -17.6 +/- 3.1%; P < 0.001; LSR(S) from -1.03 +/- 0.21 s-1 to -1.21 +/- 0.19 s-1; P < 0.001 and LSR (E) from -1.15 +/- 0.42 s-1 to 1.51 +/- 0.44 s-1; P < 0.001). Circumferential strain and strain rate values remained unchanged after CoreValve implantation. RS (29.1 +/- 17.1 to 34.0 +/- 15.8%; ns), RSR (S) (1.56 +/- 0.69 to 1.91 +/- 0.87 s-1; ns) and RSR(E) (-1.56 +/- 0.78 to -1.81 +/- 0.82 s-1; ns) increased only nonsignificantly after TAVI. Analysis of covariance showed only chronic kidney disease to have a relevant impact on early diastolic LSR (P = 0.01). Conclusions: Mainly longitudinal mechanics respond to unloading of the left ventricle after TAVI for severe aortic stenosis while radial and circumferential deformation is substantially unchanged. Pacemaker implantation or onset of left bundle brunch block after TAVI do not influence early myocardial deformation parameters. (Echocardiography 2011;28:397-401).
引用
收藏
页码:397 / 401
页数:5
相关论文
共 16 条
[1]   Acute improvement in global and regional left ventricular systolic function after percutaneous heart valve implantation in patients with symptomatic aortic stenosis [J].
Bauer, F ;
Eltchaninoff, H ;
Tron, C ;
Lesault, PF ;
Agatiello, C ;
Nercolini, D ;
Derumeaux, G ;
Cribier, A .
CIRCULATION, 2004, 110 (11) :1473-1476
[2]   Analysis of myocardial deformation based on pixel tracking in two dimensional echocardiographic images enables quantitative assessment of regional left ventricular function [J].
Becker, M. ;
Bilke, E. ;
Kuehl, H. ;
Katoh, M. ;
Kramann, R. ;
Franke, A. ;
Buecker, A. ;
Hanrath, P. ;
Hoffmann, R. .
HEART, 2006, 92 (08) :1102-1108
[3]   Impact of left ventricular loading conditions on myocardial deformation parameters:: Analysis of early and late changes of myocardial deformation parameters after aortic valve replacement [J].
Becker, Michael ;
Kramann, Rafael ;
Dohmen, Guido ;
Lueckhoff, Andreas ;
Autschbach, Ruediger ;
Kelm, Malte ;
Hoffmann, Rainer .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2007, 20 (06) :681-689
[4]   Differential effects of afterload on left ventricular long- and short-axis function: Insights from a clinical model of patients with aortic valve stenosis undergoing aortic valve replacement [J].
Carasso, Shemy ;
Cohen, Oved ;
Mutlak, Diab ;
Adler, Zvi ;
Lessick, Jonathan ;
Reisner, Shimon A. ;
Rakowski, Harry ;
Bolotin, Gil ;
Agmon, Yoram .
AMERICAN HEART JOURNAL, 2009, 158 (04) :540-545
[5]   Epidemiology and pathophysiology of left ventricular abnormalities in chronic kidney disease: a review [J].
Cerasola, Giovanni ;
Nardi, Emilio ;
Palermo, Alessandro ;
Mule, Giuseppe ;
Cottone, Santina .
JOURNAL OF NEPHROLOGY, 2011, 24 (01) :1-10
[6]   Myocardial deformation in aortic valve stenosis: relation to left ventricular geometry [J].
Cramariuc, Dana ;
Gerdts, Eva ;
Davidsen, Einar Skulstad ;
Segadal, Leidulf ;
Matre, Knut .
HEART, 2010, 96 (02) :106-112
[7]   Segmental and global longitudinal strain and strain rate based on echocardiography of 1266 healthy individuals: the HUNT study in Norway [J].
Dalen, Havard ;
Thorstensen, Anders ;
Aase, Svein A. ;
Ingul, Charlotte B. ;
Torp, Hans ;
Vatten, Lars J. ;
Stoylen, Asbjorn .
EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY, 2010, 11 (02) :176-183
[8]   Strain analysis in patients with severe aortic stenosis and preserved left ventricular ejection fraction undergoing surgical valve replacement [J].
Delgado, Victoria ;
Tops, Laurens F. ;
van Bommel, Rutger J. ;
van der Kley, Frank ;
Marsan, Nina Ajmone ;
Klautz, Robert J. ;
Versteegh, Michel I. M. ;
Holman, Eduard R. ;
Schalij, Martin J. ;
Bax, Jeroen J. .
EUROPEAN HEART JOURNAL, 2009, 30 (24) :3037-3047
[9]   Quantifying the Role of Regional Dyssynchrony on Global Left Ventricular Performance [J].
Lamia, Bouchra ;
Tanabe, Masaki ;
Kim, Hyung Kook ;
Johnson, Lauren ;
Gorcsan, John, III ;
Pinsky, Michael R. .
JACC-CARDIOVASCULAR IMAGING, 2009, 2 (12) :1350-1356
[10]   Experimental validation of a new ultrasound method for the simultaneous assessment of radial and longitudinal myocardial deformation independent of insonation angle [J].
Langeland, S ;
D'hooge, J ;
Wouters, PF ;
Leather, HA ;
Claus, P ;
Bijnens, B ;
Sutherland, GR .
CIRCULATION, 2005, 112 (14) :2157-2162