Ventricular Function In Aortic Stenosis Research Articles

325 - Assessment of the positive work and mechanical dispersion: new methods to quantify left ventricular function in aortic stenosis

325 - Assessment of the positive work and mechanical dispersion: new methods to quantify left ventricular function in aortic stenosis

Abstract 12776: Novel Left Ventricle Contractility Index as a Marker of Left Ventricular Function in Aortic Stenosis

Introduction: The maximal rate of change of pressure-normalized wall stress dσ*/dt max is a novel, non-invasive, load-independent index of left ventricular (LV) global contractility. We aim to evaluate the relationship between dσ*/dt max and aortic stenosis (AS). Methods: 417 patients with severe AS (aortic valve area [AVA] <1cm 2 ) and no more than moderate concomitant other valvular pathology underwent echocardiography to characterise LV dimension, structure and dσ*/dt max . Univariate and multivariate analyses were performed. Results: Critical and non critical severe AS were defined as AVA≤0.8cm 2 and AVA≤1.0cm 2 respectively. Univariate analysis is presented in Table 1. dσ*/dt max was reduced in subjects with critical severe AS compared to non-critical severe AS (2.17± 0.79s-1 vs 2.46 ± 0.82s-1, p<0.001). Furthermore, dσ*/dt max was found to correlate with other indices of AS severity. Multivariate analysis showed that dσ*/dt max correlated with indexed AVA (B=0.20, p<0.001), LV ejection fraction (B=0.154, p<0.001), cardiac output (B=0.377, p<0.001) and LV mass index (B=-0.664, p<0.001). dσ*/dt max did not co-relate with age, gender, body mass index or body surface area. Conclusions: dσ*/dt max correlates with indices of AS severity and may be a reflection of underlying LV dysfunction in severe AS.

Oral session V: New Insights on left ventricular function in aortic stenosis * Friday 10 December 2010, 08:30-10:00

Oral session V: New Insights on left ventricular function in aortic stenosis * Friday 10 December 2010, 08:30-10:00

Section 15: Management of Heart Failure in Special Populations

Section 15: Management of Heart Failure in Special Populations

Matters of Sex

Despite the popular concept that heart disease preferentially affects the male population, in every year for the past 16 years, cardiovascular disease has killed more women than men.1 Unfortunately, a disparity still exists between men and women in the diagnosis and aggressive treatment of heart disease. The perception that women are relatively protected is reflected by the fact that women are much more fearful of dying from some form of cancer than from cardiovascular disease.1 Understanding any risk factors that predispose or protect the female population from cardiovascular and coronary disease is therefore a compelling goal for the research community. See p 1419 Left ventricular hypertrophy is a compensatory response of the heart to a variety of stresses, and it is a strong predictor of morbidity and mortality in individuals whether or not they have been diagnosed with cardiovascular disease. Sex differences in the development of this disease over time have been suggested by clinical studies dealing with patients who suffer from aortic stenosis or hypertension.2,3 For example, older female patients with aortic stenosis tend to have increased hypertrophy accompanied by greater concentric remodeling and preserved left ventricular function when compared with male patients. Premenopausal women, in fact, exhibit a thinner posterior wall, smaller left ventricular mass, and better load-dependent and load-independent cardiac function than age-matched men under conditions of mild essential hypertension.4 Population studies have shown an age-dependent increase in left ventricular mass in healthy normotensive women that is not seen in men, as determined by echocardiography.5 These and many other studies in both humans and animals suggest that estrogens can affect the remodeling of the heart. Estrogens are potent vasodilators; they act in this capacity by increasing nitric oxide production. However, recent findings indicate that estrogens have direct actions on the myocardium as …

Usefulness of Parameters of Left Ventricular Wall Stress and Systolic Function in the Evaluation of Patients with Aortic Stenosis.

Left ventricular function and myocardial contractility in aortic stenosis have been intensely studied over the past 40 years. The underlying impetus for a good deal of this work has been to define the interaction between the ventricle and the valve, to predict in an individual patient the clinical course and outcome after aortic valve replacement. Furthermore, the relationship between afterload (wall stress) and contractility has been closely examined. Although wall stress has been shown to be inversely correlated to ejection fraction or fiber shortening, there is wide individual variability for a similar degree of valvular stenosis, which renders interpretation of data regarding left ventricular function and myocardial contractility difficult. A number of other factors affect the response of the left ventricle to chronic pressure overload. The use of stress-shortening relationships in patients with aortic stenosis requires further study before these measures can be advocated for clinical use. This review examines the usefulness of left ventricular wall stress and parameters of left ventricular function in aortic stenosis, dealing with basic concepts, echocardiographic approach, and clinical usefulness.

Determinants of ventricular function in pressure-overload hypertrophy in man.

Determinants of ventricular function in pressure-overload hypertrophy in man.

Left ventricular function in aortic stenosis: Response to exercise and effects of operation

Left ventricular function in aortic stenosis: Response to exercise and effects of operation