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Faganello G, Collia D, Pagura L, Croatto E, Tosoni LM, Toritto P, Pedrizzetti G, Lenarda AD. Impact of left ventricular hemodynamic forces in adult patients with treated aortic coarctation and preserved left ventricular systolic function. Echocardiography 2024; 41:e15742. [PMID: 38284680 DOI: 10.1111/echo.15742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/13/2023] [Accepted: 12/30/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND The LV myocardial strain and hemodynamic forces (HDFs) are innovative markers of LV function. Aortic coarctation is safely repaired in infancy; however, mortality and morbidity remain increased in later life. The study investigated the role of left ventricular myocardial deformation and HDFs in asymptomatic patients who underwent successful aortic coarctation repair. METHODS Clinical and echocardiographic data were analyzed from 42 repaired CoA, 32 ± 20 years after surgery, 2D echocardiographic global longitudinal strain (GLS), circumferential strain (GCS) and HDFs were determined. CoA patients were compared with 42 patients affected by blood hypertension and 84 healthy controls; all matched for age and gender. RESULTS All groups had normal LV ejection fraction (LVEF), dimensions, and volumes. CoA patients showed a significantly higher rate of LV mass indexed (p < .001) and left atrial volumes indexed (p < .001). LV myocardial and endocardial global longitudinal and circumferential strain were decreased in CoA patients (p < .001, p < .001; p = .032 and p < .001, respectively). HDF parameters such as LV longitudinal force, LV systolic longitudinal force and LV impulse (LVim) were uniformly reduced (p = .006, p = .001, and p = .001, respectively). LV myocardial strain and HDF parameter values were independently associated with hospitalization for heart failure on univariable Cox regression analysis. CONCLUSION Despite preserved LVEF, patients with CoA had lower LV myocardial strain and HDF parameters values, independently associated with hospitalization for heart failure.
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Affiliation(s)
- Giorgio Faganello
- Cardiovascular Center, University Hospital and Health Services of Trieste, Trieste, Italy
| | - Dario Collia
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Linda Pagura
- Cardiovascular Center, University Hospital and Health Services of Trieste, Trieste, Italy
| | - Elisa Croatto
- Cardiovascular Center, University Hospital and Health Services of Trieste, Trieste, Italy
| | - Letizia Maria Tosoni
- Cardiovascular Center, University Hospital and Health Services of Trieste, Trieste, Italy
| | - Paolo Toritto
- Cardiovascular Center, University Hospital and Health Services of Trieste, Trieste, Italy
| | - Gianni Pedrizzetti
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Andrea Di Lenarda
- Cardiovascular Center, University Hospital and Health Services of Trieste, Trieste, Italy
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Reiber JHC. Editor's choice to the March 2023 issue. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:463-464. [PMID: 36788183 DOI: 10.1007/s10554-023-02812-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Johan H C Reiber
- Leiden University Medical Center, Department of Radiology, Leiden, Netherlands.
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Vairo A, Zaccaro L, Ballatore A, Airale L, D’Ascenzo F, Alunni G, Conrotto F, Scudeler L, Mascaretti D, Miccoli D, Torre ML, Rinaldi M, Pedrizzetti G, Salizzoni S, De Ferrari GM. Acute Modification of Hemodynamic Forces in Patients with Severe Aortic Stenosis after Transcatheter Aortic Valve Implantation. J Clin Med 2023; 12:jcm12031218. [PMID: 36769866 PMCID: PMC9917967 DOI: 10.3390/jcm12031218] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/19/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Transcatheter aortic valve implantation (TAVI) is the established first-line treatment for patient with severe aortic stenosis not suitable for surgery. Echocardiographic evaluation of hemodynamic forces (HDFs) is a growing field, holding the potential to early predict improvement in LV function. A prospective observational study was conducted. Transthoracic echocardiography was performed before and after TAVI. HDFs were analyzed along with traditional left ventricular (LV) function parameters. Twenty-five consecutive patients undergoing TAVI were enrolled: mean age 83 ± 5 years, 74.5% male, mean LV Ejection Fraction (LVEF) at baseline 57 ± 8%. Post-TAVI echocardiographic evaluation was performed 2.4 ± 1.06 days after the procedure. HDF amplitude parameters improved significantly after the procedure: LV Longitudinal Forces (LF) apex-base [mean difference (MD) 1.79%; 95% CI 1.07-2.5; p-value < 0.001]; LV systolic LF apex-base (MD 2.6%; 95% CI 1.57-3.7; p-value < 0.001); LV impulse (LVim) apex-base (MD 2.9%; 95% CI 1.48-4.3; p-value < 0.001). Similarly, HDFs orientation parameters improved: LVLF angle (MD 1.5°; 95% CI 0.07-2.9; p-value = 0.041); LVim angle (MD 2.16°; 95% CI 0.76-3.56; p-value = 0.004). Conversely, global longitudinal strain and LVEF did not show any significant difference before and after the procedure. Echocardiographic analysis of HDFs could help differentiate patients with LV function recovery after TAVI from patients with persistent hemodynamic dysfunction.
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Affiliation(s)
- Alessandro Vairo
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
- Correspondence: (A.V.); (L.A.); Tel.: +39-011-6335511 (A.V.); +39-011-6336953 (L.A.); Fax: +39-011-6336015 (A.V.); +39-011-6336952 (L.A.)
| | - Lorenzo Zaccaro
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Andrea Ballatore
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Lorenzo Airale
- Internal Medicine and Hypertension Division, Department of Medical Sciences, Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy
- Correspondence: (A.V.); (L.A.); Tel.: +39-011-6335511 (A.V.); +39-011-6336953 (L.A.); Fax: +39-011-6336015 (A.V.); +39-011-6336952 (L.A.)
| | - Fabrizio D’Ascenzo
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Gianluca Alunni
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Federico Conrotto
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Luca Scudeler
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Daniela Mascaretti
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Davide Miccoli
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Michele La Torre
- Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza di Torino, University of Turin, 10126 Torino, Italy
| | - Mauro Rinaldi
- Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza di Torino, University of Turin, 10126 Torino, Italy
| | - Gianni Pedrizzetti
- Department of Engineering and Architecture, University of Trieste, 34127 Trieste, Italy
| | - Stefano Salizzoni
- Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza di Torino, University of Turin, 10126 Torino, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
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