Physiologic compensation is supranormal in compensated aortic stenosis: Does it return to normal after aortic valve replacement or is it blunted by coexistent coronary artery disease? An intramyocardial magnetic resonance imaging study

In compensated aortic stenosis (AS), cardiac performance measured at the ventricular chamber is typically supranormal, whereas measurements at the myocardium are often impaired. We investigated intramyocardial mechanics after aortic valve replacement (AVR) and the effects relative to the presence or...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2005-08, Vol.112 (9), p.I429-I436
Main Authors: BIEDERMAN, Robert W. W, DOYLE, Mark, BIEDERMAN, Caroline M, MANKAD, Sunil, MAGOVERN, James A, REICHEK, Nathaniel, YAMROZIK, June, WILLIAMS, Ronald B, RATHI, Vikas K, VIDO, Diane, CARUPPANNAN, Ketheswaram, OSMAN, Nael, BRESS, Valerie, RAYARAO, Geetha
Format: Article
Language:English
Subjects:
Adaptation, Physiological
Aged
Aged, 80 and over
Aortic Valve Stenosis - complications
Aortic Valve Stenosis - physiopathology
Aortic Valve Stenosis - surgery
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Coronary Disease - complications
Coronary Disease - physiopathology
Coronary heart disease
Diseases of the aorta
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Female
Heart
Heart Valve Prosthesis Implantation
Humans
Hypertrophy, Left Ventricular - etiology
Hypertrophy, Left Ventricular - physiopathology
Magnetic Resonance Imaging - methods
Male
Medical sciences
Middle Aged
Postoperative Period
Stress, Mechanical
Systole
Ventricular Function, Left
Ventricular Remodeling
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Summary:In compensated aortic stenosis (AS), cardiac performance measured at the ventricular chamber is typically supranormal, whereas measurements at the myocardium are often impaired. We investigated intramyocardial mechanics after aortic valve replacement (AVR) and the effects relative to the presence or absence of coronary artery disease (CAD+ or CAD-), respectively. Twenty-nine patients (46 to 91 years, 10 female) with late but not decompensated AS underwent cardiovascular MRI before AVR (PRE), with follow-up at 6+/-1 (EARLY) and 13+/-2 months (LATE) to determine radiofrequency tissue-tagged left ventricle (LV) transmural circumferential strain, torsion, structure, and function. At the myocardial level, concentric LV hypertrophy regressed 18% LATE (93+/-22 versus 77+/-17 g/m2; P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.104.525501