Relation of midwall circumferential systolic stress to equatorial midwall fibre shortening in chronic aortic regurgitation. Value as a predictor of postoperative outcome.

Abstract

SUMMARY Nineteen patients with chronic aortic regurgitation and a large increase in heart size were studied before aortic valve replacement. By relating midwall circumferential systolic stress to midwall circumferential fibre shortening (Cs/Cd) before operation the patients could be divided into two well defined groups. Twelve patients (group 1) had a pronounced decrease in heart size as measured by the cardiothoracic ratio and an excellent clinical outcome six months after operation. Seven patients (group 2) had no significant decrease in heart size and a less good clinical outcome. The ratio of midwall circumferential systolic stress to end systolic volume index was significantly higher in group 1 than in group 2. Group 2 had more severe left ventricular hypertrophy determined by the ratio of the wall thickness to the minor internal radius of the left ventricle (h:r ratio), total left ventricular mass, and left ventricular mass to end diastolic volume ratio. There were no significant differences in any other haemodynamic or angiographic indices between the two groups.Thus the relation of midwall circumferential systolic stress to fibre shortening is useful in determining the prognosis in individual patients with chronic aortic regurgitation undergoing aortic valve replacement.

A new method to estimate left ventricular circumferential midwall systolic function by standard echocardiography: Concordance between models and validation by speckle tracking

“…Green boxes show the numbers of patients that were not reclassified. predictor of adverse outcome in different pathologic conditions [10,[35][36][37][38][39][40]. Although to date the performance of circumferential fibers can be explored using more advanced echocardiographic techniques such as speckle tracking, methods based on conventional echocardiography still have a role in daily practice, as they can allow a rapid detection of LV circ dysfunction without the need of relatively time-consuming offline analyses.…”