Download pdf - PREDICTION OF IMMEDIATE LEFT VENTRICULAR DYSFUNCTION AFTER SUCCESSFUL AORTIC VALVE SURGERY FOR SEVERE AORTIC REGURGITATION: CONVENTIONAL TWO-DIMENSIONAL VERSUS SPECKLE-TRACKING PARAMETERS

Non Invasive Imaging

A1035JACC April 1, 2014

Volume 63, Issue 12

predicTion of iMMediaTe lefT venTricUlar dysfUncTion afTer sUccessfUl aorTic valve sUrgery for severe aorTic regUrgiTaTion: convenTional Two-diMensional versUs speckle-Tracking paraMeTers

Poster ContributionsHall CSaturday, March 29, 2014, 10:00 a.m.-10:45 a.m.

Session Title: Non Invasive Imaging: Advances in Aortic Valve DiseaseAbstract Category: 15. Non Invasive Imaging: EchoPresentation Number: 1102-46

Authors: Jeong Yoon Jang, Jong-Min Song, Min Jung Sin, Eun Jeong Lee, Hanul Choi, Jihyun Sohn, Cheol Hyun Chung, Jae Won Lee, Byung Joo Sun, Dae-hee Kim, Duk-Hyun Kang, Jae-Kwan Song, Asan Medical Center, Seoul, South Korea

Background: We aimed to investigate speckle-tracking parameters in prediction of postoperative left ventricular (LV) dysfunction after aortic valve (AV) surgery in patients with severe aortic regurgitation (AR).

Methods: Two-dimensional echocardiography and speckle-tracking imaging for global longitudinal, circumferential and radial strain or strain rate were performed in a total of 127 consecutive severe AR patients (age:48±15 years, 89 males) and postoperative LV ejection fraction (EF) was evaluated within 7 days after surgery.

results: EF was significantly decreased after AV surgery compared with preoperative value (52.5±7.9 to 42.6±11.0, %, p<0.01). In univariate linear regression analyses, preoperative LV dimensions, volumes, EF and longitudinal, circumferential and radial strains and strain rates were correlated with postoperative EF. In multivariate analysis, preoperative LV end-systolic dimension (ß=-0.32, p=0.03) and EF (ß=0.38, p<0.01) were independent predictors of postoperative EF. ROC curve analyses showed that areas under the curve of preoperative LV end-systolic dimension and EF tended to be larger than those of speckle-tracking parameters for prediction of postoperative severe LV dysfunction (EF<35%)(Fig.).

conclusion: Although preoperative LV speckle-tracking-derived deformation parameters are associated with postoperative EF, they are not superior to conventional parameters or EF in predicting postoperative LV dysfunction in patients with severe AR.