Hulshof, HG, van Oorschot, F, van Dijk, APJ, Hopman, MTE, George, KP, Oxborough, D and Thijssen, DHJ (2019) CHANGES IN DYNAMIC LEFT VENTRICULAR FUNCTION, ASSESSED BY THE STRAIN-VOLUME LOOP, RELATE TO REVERSE REMODELLING AFTER AORTIC VALVE REPLACEMENT. Journal of Applied Physiology. ISSN 8750-7587

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Abstract

OBJECTIVES: Aortic valve replacement (AVR) leads to remodelling of the left ventricle (LV). Adopting a novel technique to examine dynamic LV function, our study explored whether post-AVR changes in dynamic LV function and/or changes in aortic valve characteristics are associated with LV mass regression during follow-up. METHODS AND RESULTS: We retrospectively analysed 30 participants with severe aortic stenosis who underwent standard transthoracic echocardiographic assessment prior to AVR (88[22-143] days), post-AVR (13[6-22] days) and during follow-up (455[226-907] days). We assessed standard measures of LV structure, function and aortic valve characteristics. Novel insight into dynamic LV function was provided through a 4-chamber image by examination of the temporal relation between LV longitudinal strain (ԑ) and volume (ԑ-volume loops), representing the contribution of LV mechanics to volume change. AVR resulted in immediate changes in structural valve characteristics, alongside a reduced LV longitudinal peak ԑ and improved coherence between the diastolic and systolic part of the ԑ-volume loop (all P<0.05). Follow-up revealed a decrease in LV mass (P<0.05) and improvements in LV ejection fraction and LV longitudinal peak ԑ (P<0.05). A significant relationship was present between decline in LV mass during follow-up and post-AVR improvement in coherence of the ԑ-volume loops (r=0.439, P=0.03), but not with post-AVR changes in aortic valve characteristics or LV function (all P>0.05). CONCLUSIONS: We found that post-AVR improvements in dynamic LV function, are related to long-term remodelling of the left ventricle. This highlights the potential importance of assessing dynamic LV function for cardiac adaptations in vivo.

Item Type:	Article
Uncontrolled Keywords:	06 Biological Sciences, 11 Medical and Health Sciences
Subjects:	Q Science > QP Physiology
Divisions:	Sport & Exercise Sciences
Publisher:	American Physiological Society
Related URLs:	Author
Date Deposited:	08 Jul 2019 14:46
Last Modified:	20 Feb 2023 15:46
DOI or ID number:	10.1152/japplphysiol.00190.2019
URI:	https://researchonline.ljmu.ac.uk/id/eprint/11004

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