Peak systolic myocardial velocity in patients undergoing surgical aortic valve replacement for severe aortic stenosis: prognostic value and natural course

Myocardial systolic longitudinal function has been known to decrease in patients with severe aortic stenosis (AS). Preoperative peak systolic myocardial velocity at the septal mitral valve annulus (S’), measured using Doppler tissue imaging, was used as an indicator for myocardial systolic longitudi...

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Bibliographic Details
Published in:Journal of clinical monitoring and computing 2023-02, Vol.37 (1), p.327-336
Main Authors: Chin, Ji-Hyun, Kim, Sehee, Kim, Dongho, Nam, Jae-Sik, Kim, Kyungmi, Choi, In-Cheol
Format: Article
Language:English
Subjects:
Anesthesiology
Aorta
Aortic stenosis
Aortic Valve - surgery
Aortic Valve Stenosis - surgery
Critical Care Medicine
Echocardiography, Doppler
Health Sciences
Heart valves
Humans
Intensive
Medicine
Medicine & Public Health
Mortality
Multivariate analysis
Original Research
Prognosis
Spline functions
Statistics for Life Sciences
Surgery
Systole
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Summary:Myocardial systolic longitudinal function has been known to decrease in patients with severe aortic stenosis (AS). Preoperative peak systolic myocardial velocity at the septal mitral valve annulus (S’), measured using Doppler tissue imaging, was used as an indicator for myocardial systolic longitudinal function. The prognostic value and natural course of S’ after surgical aortic valve replacement for severe AS have not been elucidated. This retrospective observational study included patients from January 2006 to December 2018. The patients were divided to 2 groups (pre-S’ HIGH vs. pre-S’ LOW ) with a cut-off 5.4 cm/s of preoperative S’ (pre-S’) that was identified by restricted cubic spline curve. The primary outcome was postoperative long-term all-cause mortality. Nine hundred and five patients were analyzed. All-cause mortality rate at the median follow-up period of 5.2 years was 12% in pre-S’ LOW and 8% in pre-S’ HIGH . Multivariate analysis showed that pre-S’ LOW was associated with an increased all-cause mortality (hazard ratio, 1.60; 95% confidence interval, 1.04–2.48; P  = 0.032). Significantly different trajectories of postoperative S’ (post-S’) were found between two groups ( P  
ISSN:1387-1307
1573-2614
DOI:10.1007/s10877-022-00896-0