Impact of global left ventricular afterload on left ventricular function in asymptomatic severe aortic stenosis: a two-dimensional speckle-tracking study.

Lancellotti, Patrizio; Donal, Erwan; Magne, Julien; O'Connor, Kim; Moonen, Marie; Cosyns, Bernard; Pierard, Luc

doi:10.1093/ejechocard/jeq014

Article (Scientific journals)

Impact of global left ventricular afterload on left ventricular function in asymptomatic severe aortic stenosis: a two-dimensional speckle-tracking study.

Lancellotti, Patrizio; Donal, Erwan; Magne, Julien et al.

2010 • In European Journal of Echocardiography, 11 (6), p. 537-543

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/19477

DOI
10.1093/ejechocard/jeq014

PubMed
20202992

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Keywords :

Aortic stenosis; Echocardiography; Left ventricular function

Abstract :

[en] Aims: The present study sought to assess the effect of global left ventricular (LV) afterload on LV myocardial systolic function in patients with aortic stenosis (AS) and preserved LV ejection fraction.
Methods and results: We prospectively examined the LV myocardial deformation (i.e. longitudinal, radial, and circumferential) by two-dimensional speckle tracking in 173 patients with asymptomatic severe AS. Thirty-eight patients (22%) had lowflow as determined by a low stroke volume index (􏰀35 mL/m2). By multivariable analysis, four variables emerged as independently associated with low-flow AS: peak Ea velocity (P 1⁄4 0.01), left atrial area index (P 1⁄4 0.017), global LV afterload (P 1⁄4 0.024), and circumferential myocardial deformation (P 1⁄4 0.04). Forty-nine patients (28%) had an increased global LV afterload (􏰁5 mmHg mL/m2). Systemic arterial compliance (P 1⁄4 0.001), circumferential myocardial deformation (P 1⁄4 0.024), and left atrial area index (P 1⁄4 0.04) were independently associated with increased global LV load in multivariable analysis.
Conclusion: In asymptomatic patients with severe AS, LV ejection fraction markedly underestimates the extent of myocardial sys- tolic impairment. Intrinsic myocardial dysfunction is particularly common in patients with increased global LV after- load, and especially in the subset of patients with low-flow AS.

Research Center/Unit :

Service de Cardiologie

Disciplines :

General & internal medicine
Cardiovascular & respiratory systems

Author, co-author :

Lancellotti, Patrizio ; Université de Liège - ULiège > Cardiologie

Donal, Erwan

Magne, Julien ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation

O'Connor, Kim

Moonen, Marie ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation

Cosyns, Bernard

Pierard, Luc ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation

Language :

English

Title :

Impact of global left ventricular afterload on left ventricular function in asymptomatic severe aortic stenosis: a two-dimensional speckle-tracking study.

Publication date :

04 March 2010

Journal title :

European Journal of Echocardiography

ISSN :

1525-2167

eISSN :

1532-2114

Publisher :

Harcourt Publishers Limited

Volume :

Issue :

Pages :

537-543

Peer reviewed :

Peer Reviewed verified by ORBi

Funders :

F.R.S.-FNRS - Fonds de la Recherche Scientifique

Available on ORBi :

since 16 March 2010

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129

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102

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151

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