Sequential changes in myocardial function after valve replacement for aortic stenosis by speckle tracking echocardiography

Eur J Echocardiogr. 2010 Aug;11(7):584-9. doi: 10.1093/ejechocard/jeq017. Epub 2010 Mar 2.

Abstract

Aims: Regional myocardial function may change differently in different pathology. Speckle tracking echocardiography (STE) was applied to evaluate longitudinal, radial, and circumferential function in patients with aortic stenosis (AS) before, within 1 week, and 6 months after aortic valve replacement (AVR).

Methods and results: In 40 consecutive patients with severe AS, we acquired apical four-, three-, and two-chamber views and standard short-axis view pre- and post-AVR and after 6 months. Longitudinal, radial, and circumferential (LS, RS, and CS) were calculated by commercial STE software. Further, we analysed diastolic myocardial function by measuring E/e' ratio. With AVR, valve area increased and remained stable at 6 months follow-up. Left ventricular mass was unchanged 1 week after AVR (270 +/- 58 g vs. 267 +/- 58 g, n.s.) but decreased significantly during the next 6 months (219 +/- 50 g, P < 0.05). Left ventricular ejection fraction remained unchanged. Strain values did not change significantly within 1 week after AVR but increased significantly after 6 months (LS by 16%, RS by 21%, and CS by 28% of baseline values). E/e' ratio was highly augmented before AVR (26.1 +/- 12.5) and decreased significantly 6 months after AVR (15.9 +/- 5.9).

Conclusion: Myocardial function significantly recovers after replacing the stenosed aortic valve. However, there is a considerable difference between the response of longitudinal, radial, and circumferential function. Our data suggest that echocardiographic assessment of regional function is feasible and of potential clinical importance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aortic Valve / diagnostic imaging*
  • Aortic Valve / physiopathology*
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / diagnostic imaging*
  • Aortic Valve Stenosis / physiopathology*
  • Aortic Valve Stenosis / surgery
  • Echocardiography / methods*
  • Female
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation*
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Postoperative Care
  • Preoperative Care
  • Recovery of Function
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Treatment Outcome
  • Ventricular Dysfunction, Left / prevention & control*