Acute left ventricle diastolic function improvement after transcatheter aortic valve implantation

Gonçalves, Alexandra; Marcos‐Alberca, Pedro; Almerı́a, Carlos; Feltes, Gisela; Rodrı́guez, Enrique; Hernández-Antolín, Rosa Ana; Garcı́a, Eulogio; Maroto, Luis; Pérez, Cristina Fernández; Silva-Cardoso, José; Macaya, Carlos; Zamorano, José Luís

doi:10.1093/ejechocard/jer147

Cited by 55 publications

(49 citation statements)

References 27 publications

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“…In addition, E and E' increased significantly after TAVI. These results are consistent with previously published data from Gonçalves et al [35] and Guarracino et al [36], who measured LV relaxation parameters within minutes of TAVI.…”

Section: Discussionsupporting

confidence: 93%

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Immediate recovery of the left atrial and left ventricular diastolic function after transcatheter aortic valve implantation: A transesophageal echocardiography study

Sarı

Aslan²,

Baştuğ³

et al. 2016

Cardiol J.

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LV diastolic function was also explored by pulsed tissue Doppler imaging (TDI). Early (E') and late (A') diastolic annular velocities, E'/A' ratio and E/E' ratio were obtained. In addition, during the procedure before and minutes after the valve implantation, the left atrial appendage-peak antegrade flow velocity (LAA-PAFV) was measured and recorded with TEE.Results: Compared with baseline, the mean mitral E, septal E' and E'/A' ratio increased significantly after TAVI. In addition, the LAA-PAFV increased significantly within minutes of TAVI (32.45 ± 10.7 cm/s vs. 47.6 ± 12.6 cm/s, p < 0.001

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Section: Discussionsupporting

confidence: 93%

“…After TAVI, our patients showed significant increases in effective orifice area and marked decreases in transvalvular pressure gradients, equivalent to a reduction in LV afterload [35]. In addition, E and E' increased significantly after TAVI.…”

Section: Discussionmentioning

confidence: 53%

Immediate recovery of the left atrial and left ventricular diastolic function after transcatheter aortic valve implantation: A transesophageal echocardiography study

Sarı

Aslan²,

Baştuğ³

et al. 2016

Cardiol J.

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“…They explained this by the impediment of the reduction in afterload due to the cardioplegia and cardiopulmonary bypass after s-AVR [22]. Gonçalves et al [23] have showed the reduction of LV end-diastolic pressure with an invasive method just a minute after TAVI and detected this without any change in echocardiographic E/É'ratio [23]. www.cardiologyjournal.org Impaired LV diastolic function is an independent risk factor for early-and late-term mortality in patients with AS after s-AVR.…”

Section: Discussionmentioning

confidence: 99%

Impact of transcatheter aortic valve implantation on the left ventricular mass

et al. 2015

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001). There were no significant changes between the baseline and discharge mean LVM and LVM index values (LVMI; p = 0.1). However, LVMI decreased significantly in the 1st month of follow-up compared to baseline (123.3 ± ± 20.3 to 127.9 ± 21.3 g/m 2 , respectively, p < 0.001). Also, significant regression of LVM was observed at the 1 st month of follow-up compared to baseline (228.3 ± 33.5 g vs. 236.5 ± 34.2 g, respectively, p < 0.001 (Cardiol J 2015; 22, 6: 645-650)

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“…22 Consequently, one may expect a decreased baseline and increased hyperemic flow velocity after TAVI. However, mean flow velocities were unchanged by TAVI, and CFR remained below 2 in our AS patients.…”

Section: Effect Of As and Tavi On Coronary Flow Velocity And Cfrmentioning

confidence: 99%

Transcatheter Replacement of Stenotic Aortic Valve Normalizes Cardiac–Coronary Interaction by Restoration of Systolic Coronary Flow Dynamics as Assessed by Wave Intensity Analysis

Rolandi

Wiegerinck

Casadonte

et al. 2016

Circ: Cardiovascular Interventions

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Background-Aortic valve stenosis (AS) can cause angina despite unobstructed coronary arteries, which may be related to increased compression of the intramural microcirculation, especially at the subendocardium. We assessed coronary wave intensity and phasic flow velocity patterns to unravel changes in cardiac-coronary interaction because of transcatheter aortic valve implantation (TAVI). Methods and Results-Intracoronary pressure and flow velocity were measured at rest and maximal hyperemia in undiseased vessels in 15 patients with AS before and after TAVI and in 12 control patients. Coronary flow reserve, systolic and diastolic velocity time integrals, and the energies of forward (aorta-originating) and backward (microcirculatoryoriginating) coronary waves were determined. Coronary flow reserve was 2.8±0.2 (mean±SEM) in control and 1.8±0.1 in AS (P<0.005) and was not restored by TAVI. Compared with control, the resting backward expansion wave was 45% higher in AS. The peak of the systolic forward compression wave was delayed in AS, consistent with a delayed peak aortic pressure, which was partially restored after TAVI. The energy of forward waves doubled after TAVI, whereas the backward expansion wave increased by >30%. The increase in forward compression wave with TAVI was related to an increase in systolic velocity time integral. AS or TAVI did not alter diastolic velocity time integral. Conclusions-Reduced coronary forward wave energy and systolic velocity time integral imply a compromised systolic flow velocity with AS that is restored after TAVI, suggesting an acute relief of excess compression in systole that likely benefits subendocardial perfusion. Vasodilation is observed to be a major determinant of backward waves. (Circ Cardiovasc Interv. 2016;9:e002356.

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Acute left ventricle diastolic function improvement after transcatheter aortic valve implantation

Abstract: This is the first study describing LV diastolic performance during TAVI. Our results show improvement in diastolic function parameters in patients with preserved LV systolic function, immediately after successful TAVI.

Cited by 55 publications

References 27 publications

Immediate recovery of the left atrial and left ventricular diastolic function after transcatheter aortic valve implantation: A transesophageal echocardiography study

Immediate recovery of the left atrial and left ventricular diastolic function after transcatheter aortic valve implantation: A transesophageal echocardiography study

Impact of transcatheter aortic valve implantation on the left ventricular mass

Transcatheter Replacement of Stenotic Aortic Valve Normalizes Cardiac–Coronary Interaction by Restoration of Systolic Coronary Flow Dynamics as Assessed by Wave Intensity Analysis

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