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CHANGES IN DYNAMIC LEFT VENTRICULAR FUNCTION, ASSESSED BY THE STRAIN-VOLUME LOOP, RELATE TO REVERSE REMODELLING AFTER AORTIC VALVE REPLACEMENT.

Hulshof, HG, van Oorschot, F, van Dijk, APJ, Hopman, MTE, George, KP, Oxborough, DL 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: Sports & Exercise Sciences
Publisher: American Physiological Society
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Date Deposited: 08 Jul 2019 14:46
Last Modified: 08 Jul 2019 14:46
DOI or Identification number: 10.1152/japplphysiol.00190.2019
URI: http://researchonline.ljmu.ac.uk/id/eprint/11004

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