Work

Effect of balloon aortic valvuloplasty on Doppler indexes of left ventricular diastolic filling

Year: 1991

Type: article

Abstract: L eft ventricular (LV) hypertrophy, developing in re- sponse to chronic pressure overload, serves to normalize systolic wall stress and preserve systolic functi0n.lHowever, thii occurs at the expense of an impairment of LV isovolumic relaxation and early diastolic filling.2Increases in LV afterload have also been thought to cause acute impairment in ventricular relaxation.This study sought to determine whether percutaneous balloon aortic valvuloplasty, by reducing afterload in patients with LV hypertrophy due to aortic stenosis, would result in an early favorable effect on Doppler echocardiographic indexes of ventricular filliig.The study population consisted of 190 consecutive patients undergoing balloon aortic valvuloplasty at the Beth Israel Hospital between December 28, 1985 and August IO, 1988.Of these, 163 patients were excluded from analysis owing to coexisting conditions associated with abnormal patterns of LV diastolic filling: prior myocardial infarction or significant coronary artery disease, defined as >50% diameter narrowing of a major epicardial vessel; greater than trivial mitral or aortic regurgitation identified by Doppler echocardiographic examination; concurrent mitral stenosis; or non-sinus rhythm (atria1 fibrillation/flutter, ventricular paced rhythm or frequent ventricular ectopic activity).Eight additional patients either did not undergo or had inadequate transmitral Doppler studies before and after valvuloplasty.The remaining 19 patients included 10 men and 9 women (mean age f standard deviation 75 f 14 years).Echocardiographic and radionuclide scintigraphy were performed inpatients 24 to 72 hours before and 48 to 72 hours after balloon aortic valvuloplasty.Informed consent was obtained from all patients, and the study protocol was approved by the Investigational Review Board of the Beth Israel Hospital, Boston, Massachusetts.Two-dimensional, M-mode and pulsed Doppler echocardiograms were obtained with an Advanced Technology Labs, Inc. model MK600 combined imaging, Mmode and Doppler echocardiograph equipped with a 3.0-MHz mechanical transducer.M-mode data were recorded of the LVseptum andposterior wall immediately

Source: The American Journal of Cardiology

DOI: 10.1016/0002-9149(91)90022-d

Authors: Warren J. Manning, Marilyn F. Riley, Patricia C. Come

Institutions: Beth Israel Deaconess Medical Center, Harvard University

Language: English

Topic: Cardiac Valve Diseases and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,380