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Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation
AIMS: Pressure overload in aortic stenosis (AS) and both pressure and volume overload in aortic regurgitation (AR) induce concentric and eccentric hypertrophy, respectively. These structural changes influence left ventricular (LV) mechanics, but little is known about the time course of LV remodellin...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753383/ https://www.ncbi.nlm.nih.gov/pubmed/30932153 http://dx.doi.org/10.1093/ehjci/jez049 |
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author | Vollema, E Mara Singh, Gurpreet K Prihadi, Edgard A Regeer, Madelien V Ewe, See Hooi Ng, Arnold C T Mertens, Bart J A Klautz, Robert J M Ajmone Marsan, Nina Bax, Jeroen J Delgado, Victoria |
author_facet | Vollema, E Mara Singh, Gurpreet K Prihadi, Edgard A Regeer, Madelien V Ewe, See Hooi Ng, Arnold C T Mertens, Bart J A Klautz, Robert J M Ajmone Marsan, Nina Bax, Jeroen J Delgado, Victoria |
author_sort | Vollema, E Mara |
collection | PubMed |
description | AIMS: Pressure overload in aortic stenosis (AS) and both pressure and volume overload in aortic regurgitation (AR) induce concentric and eccentric hypertrophy, respectively. These structural changes influence left ventricular (LV) mechanics, but little is known about the time course of LV remodelling and mechanics after aortic valve surgery (AVR) and its differences in AS vs. AR. The present study aimed to characterize the time course of LV mass index (LVMI) and LV mechanics [by LV global longitudinal strain (LV GLS)] after AVR in AS vs. AR. METHODS AND RESULTS: Two hundred and eleven (61 ± 14 years, 61% male) patients with severe AS (63%) or AR (37%) undergoing surgical AVR with routine echocardiographic follow-up at 1, 2, and/or 5 years were evaluated. Before AVR, LVMI was larger in AR patients compared with AS. Both groups showed moderately impaired LV GLS, but preserved LV ejection fraction. After surgery, both groups showed LV mass regression, although a more pronounced decline was seen in AR patients. Improvement in LV GLS was observed in both groups, but characterized by an initial decline in AR patients while LV GLS in AS patients remained initially stable. CONCLUSION: In severe AS and AR patients undergoing AVR, LV mass regression and changes in LV GLS are similar despite different LV remodelling before AVR. In AR, relief of volume overload led to reduction in LVMI and an initial decline in LV GLS. In contrast, relief of pressure overload in AS was characterized by a stable LV GLS and more sustained LV mass regression. |
format | Online Article Text |
id | pubmed-6753383 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-67533832019-09-25 Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation Vollema, E Mara Singh, Gurpreet K Prihadi, Edgard A Regeer, Madelien V Ewe, See Hooi Ng, Arnold C T Mertens, Bart J A Klautz, Robert J M Ajmone Marsan, Nina Bax, Jeroen J Delgado, Victoria Eur Heart J Cardiovasc Imaging Original Articles AIMS: Pressure overload in aortic stenosis (AS) and both pressure and volume overload in aortic regurgitation (AR) induce concentric and eccentric hypertrophy, respectively. These structural changes influence left ventricular (LV) mechanics, but little is known about the time course of LV remodelling and mechanics after aortic valve surgery (AVR) and its differences in AS vs. AR. The present study aimed to characterize the time course of LV mass index (LVMI) and LV mechanics [by LV global longitudinal strain (LV GLS)] after AVR in AS vs. AR. METHODS AND RESULTS: Two hundred and eleven (61 ± 14 years, 61% male) patients with severe AS (63%) or AR (37%) undergoing surgical AVR with routine echocardiographic follow-up at 1, 2, and/or 5 years were evaluated. Before AVR, LVMI was larger in AR patients compared with AS. Both groups showed moderately impaired LV GLS, but preserved LV ejection fraction. After surgery, both groups showed LV mass regression, although a more pronounced decline was seen in AR patients. Improvement in LV GLS was observed in both groups, but characterized by an initial decline in AR patients while LV GLS in AS patients remained initially stable. CONCLUSION: In severe AS and AR patients undergoing AVR, LV mass regression and changes in LV GLS are similar despite different LV remodelling before AVR. In AR, relief of volume overload led to reduction in LVMI and an initial decline in LV GLS. In contrast, relief of pressure overload in AS was characterized by a stable LV GLS and more sustained LV mass regression. Oxford University Press 2019-10 2019-04-01 /pmc/articles/PMC6753383/ /pubmed/30932153 http://dx.doi.org/10.1093/ehjci/jez049 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Articles Vollema, E Mara Singh, Gurpreet K Prihadi, Edgard A Regeer, Madelien V Ewe, See Hooi Ng, Arnold C T Mertens, Bart J A Klautz, Robert J M Ajmone Marsan, Nina Bax, Jeroen J Delgado, Victoria Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation |
title | Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation |
title_full | Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation |
title_fullStr | Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation |
title_full_unstemmed | Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation |
title_short | Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation |
title_sort | time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753383/ https://www.ncbi.nlm.nih.gov/pubmed/30932153 http://dx.doi.org/10.1093/ehjci/jez049 |
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