Early improvement of left ventricular function after implantation of a transcutaneous aortic valve: A tissue Doppler ultrasound study

Bénigno, Sandra; M, Lemercier; Tapiero, S.; Eltchaninoff, Hélène; Tron, Christophe; Baala, Brahim; Brunet, Damien; Cribier, Alain

doi:10.1016/j.acvd.2009.02.003

Cited by 16 publications

(11 citation statements)

References 19 publications

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“…Bauer et al [34] demonstrated an increase in E' and A' measured by pulsed TDI in LV septal wall but no difference in LV diastolic function measured by blood flow Doppler echocardiography when they examined the patients 24 h post-procedurally. 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].…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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“…The observed perioperative LV impairment is only transient as both TAVI and sAVR have been previously shown to result in improvement of LV function at later time points postprocedure 1 11. However, the transient disturbances in LV performance we describe are likely to have an impact on early postoperative recovery and may inform appropriate medical management in the immediate postprocedural period 2…”

Section: Discussionmentioning

confidence: 74%

Successful transcatheter aortic valve implantation (TAVI) is associated with transient left ventricular dysfunction

Dworakowski

Wendler

Bhan

et al. 2012

Heart

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Objective To investigate early haemodynamic changes after transfemoral transcatheter aortic valve implantation (TAVI) and the relationship with myocardial injury and neurohormonal activation. Design Single-centre prospective observational study. Setting Tertiary cardiac centre. Patients 42 patients undergoing transfemoral TAVI were included in this study. Main outcome measures Haemodynamic measurements and echocardiography-derived indices characterising myocardial function were recorded at baseline, 6 and 24 h postprocedure. Postprocedural myocardial injury was quantified using serum troponin I and CK-MB levels. In addition, biomarkers of myocardial dysfunction/heart failure and neurohormonal activation were measured. Results 6 h Post-TAVI there was a significant deterioration in both systolic and diastolic function as measured by dP/dt max /EDV, myocardial performance index and mean E/e' index. Recovery of myocardial function was observed at 24 h. These haemodynamic changes were associated with a significant increase in both troponin I (0.0760.01 vs 1.5960.21 mg/l, p<0.005) and CK-MB (1.9960.19 vs 6.8260.7 ng/ml, p<0.005). There was a positive correlation among myocardial injury and NT-BNP (r¼0.34, p<0.0005), aldosterone (r¼0.56, p<0.0001) and ST2 levels (r¼0.21, p<0.05). Conclusions This is the first study to demonstrate that procedurally successful TF-TAVI results in a transient depression of both systolic and diastolic left ventricular function within the first 24 postoperative hours, despite impressive relief of previously severe, chronic pressure overload. The rise in the markers of myocardial damage suggests that this may be due to periprocedural myocardial injury. Complete recovery of contractility is generally observed after 24 h.

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“…However, as statin therapy did not prevent the progression of AS in multiple randomized controlled studies including ASTRONOMER, SEAS and SALTIRE, [12,19,20] it is not unexpected that the degree of diastolic dysfunction continued to progress in our patient population. Following open surgical or percutaneous aortic valve replacement, it has been shown that diastolic parameters improve in both short and long term follow-up [10,21,22]. It it also plausible that our study population may have other contributing mechanisms to progressive diastolic dysfunction including underlying asymptomatic CAD that could affect the subsequent outcome.…”

Section: Discussionmentioning

confidence: 98%

Evaluating the effectiveness of rosuvastatin in preventing the progression of diastolic dysfunction in aortic stenosis: A substudy of the aortic stenosis progression observation measuring effects of rosuvastatin (ASTRONOMER) study

Jassal

Bhagirath

Karlstedt

et al. 2011

Cardiovasc Ultrasound

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BackgroundTissue Doppler imaging (TDI) is a noninvasive echocardiographic method for the diagnosis of diastolic dysfunction in patients with varying degrees of aortic stenosis (AS). Little is known however, on the utility of TDI in the serial assessment of diastolic abnormalities in AS.ObjectiveThe aim of the current proposal was to examine whether treatment with rosuvastatin was successful in improving diastolic abnormalities in patients enrolled in the Aortic Stenosis Progression Observation Measuring Effects of Rosuvastatin (ASTRONOMER) study.MethodsConventional Doppler indices including peak early (E) and late (A) transmitral velocities, and E/A ratio were measured from spectral Doppler. Tissue Doppler measurements including early (E') and late (A') velocities of the lateral annulus were determined, and E/E' was calculated.ResultsThe study population included 168 patients (56 ± 13 years), whose AS severity was categorized based on peak velocity at baseline (Group I: 2.5-3.0 m/s; Group II: 3.1-3.5 m/s; Group III: 3.6-4.0 m/s). Baseline and follow-up hemodynamics, LV dimensions and diastolic functional parameters were evaluated in all three groups. There was increased diastolic dysfunction from baseline to follow-up in each of the placebo and rosuvastatin groups. In patients with increasing severity of AS in Groups I and II, the lateral E' was lower and the E/E' (as an estimate of increased left ventricular end-diastolic pressure) was higher at baseline (p < 0.05). However, treatment with rosuvastatin did not affect the progression of diastolic dysfunction from baseline to 3.5 year follow-up between patients in any of the three predefined groups.ConclusionIn patients with mild to moderate asymptomatic AS, rosuvastatin did not attenuate the progression of diastolic dysfunction.

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Early improvement of left ventricular function after implantation of a transcutaneous aortic valve: A tissue Doppler ultrasound study

Abstract: The immediate drop in the transaortic gradient resulted in an improvement in myocardial velocities and strain, a sign of improvement in the regional systolic and diastolic regional function.

Cited by 16 publications

References 19 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

Successful transcatheter aortic valve implantation (TAVI) is associated with transient left ventricular dysfunction

Evaluating the effectiveness of rosuvastatin in preventing the progression of diastolic dysfunction in aortic stenosis: A substudy of the aortic stenosis progression observation measuring effects of rosuvastatin (ASTRONOMER) study

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