Right ventricular function in severe aortic stenosis assessed by echocardiography and MRI

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2023-11-20 DOI:10.1111/cpf.12867

Erica Holmberg, Éva Tamás, Eva Nylander, Jan Engvall, Hans Granfeldt

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引用次数: 0

Abstract

Background

The prevalence of aortic valve stenosis (AS) is increasing due to an ageing population. Despite that right ventricular function has prognostic value for postoperative outcome, the right ventricle (RV) is not extensively studied and often not routinely assessed in AS. Our aim was to explore the relation between severe AS and RV function in a surgical aortic valve replacement (SAVR) cohort, comparing two imaging modalities for RV evaluation.

Methods

Patients with severe AS, underwent cardiovascular magnetic resonance imaging (CMR) and transthoracic echocardiography (TTE) before SAVR. RV dysfunction was defined as one or more of the following: tricuspid annular plane systolic excursion (TAPSE) < 17 mm, RV free wall strain (RVFWS) > −20% by TTE and RV ejection fraction (RVEF) <50% by CMR.

Results

Sixteen (33%) patients were found to have RV dysfunction. Patients with RV dysfunction showed significantly lower indexed aortic valve area, left ventricular (LV) ejection fraction as well as RV and LV stroke volumes compared to patients with maintained RV function. All patients with reduced RVEF also had changes in TAPSE or RVFWS and a larger number of patients had a reduced longitudinal RV function despite a normal RVEF.

Conclusion

In a SAVR cohort one-third of the patients had RV dysfunction, defined by RVEF, TAPSE or RVFW strain. Echocardiography detected subtle changes in RV function before RVEF was reduced. It is likely that the more pronounced the AS, the more frequent the occurrence of RV dysfunction.

Abstract Image

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超声心动图和MRI评价重度主动脉瓣狭窄患者的右心室功能。

背景:由于人口老龄化，主动脉瓣狭窄(AS)的患病率正在上升。尽管右心室功能对术后预后有预测价值，但在AS患者中，右心室(RV)并没有得到广泛的研究，通常也没有进行常规评估。我们的目的是探讨在外科主动脉瓣置换术(SAVR)队列中严重AS与RV功能之间的关系，比较两种成像方式对RV的评估。方法:重度AS患者在SAVR前行心血管磁共振成像(CMR)和经胸超声心动图(TTE)检查。右心室功能障碍定义为以下一项或多项:三尖瓣环面收缩漂移(TAPSE) < 17 mm, TTE检测右心室游离壁应变(RVFWS) > -20%， CMR检测右心室射血分数(RVEF) < 50%。结果:16例(33%)患者有右心室功能障碍。与左室功能维持的患者相比，右室功能障碍患者的主动脉瓣指数面积、左室射血分数以及左室和左室卒中容量明显降低。所有RVEF减少的患者也有TAPSE或RVFWS的变化，尽管RVEF正常，但大量患者的纵向RV功能降低。结论:在SAVR队列中，三分之一的患者有RVEF、TAPSE或RVFW菌株定义的RV功能障碍。超声心动图检测到RVEF减少前右室功能的细微变化。AS越明显，RV功能障碍的发生就越频繁。这篇文章受版权保护。版权所有。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.