scholarly journals Association of Left Ventricular Global Longitudinal Strain during Dobutamine Stress Echocardiography with Adverse Events in Patients with Severe Low-Flow, Low-Gradient Aortic Stenosis

2020 ◽  
Vol 33 (11) ◽  
pp. 1424-1425
Author(s):  
Darae Kim ◽  
Geu-Ru Hong ◽  
Jong-Won Ha ◽  
Chi Young Shim
Keyword(s):  
Adverse Events ◽  
Aortic Stenosis ◽  
Stress Echocardiography ◽  
Longitudinal Strain ◽  
Dobutamine Stress Echocardiography ◽  
Global Longitudinal Strain ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Low Flow

scholarly journals 1677 Global longitudinal strain during dobutamine stress echocardiography can predict left ventricular remodeling after anterior wall acute myocardial infarction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T Onishi ◽  
K Iwakura ◽  
A Okamura ◽  
Y Koyama ◽  
K Inoue ◽  
...  
Keyword(s):  
Stress Echocardiography ◽  
Longitudinal Strain ◽  
Low Dose ◽  
Ventricular Remodeling ◽  
Dobutamine Stress Echocardiography ◽  
Left Ventricular Remodeling ◽  
Global Longitudinal Strain ◽  
Dobutamine Stress ◽  
Anterior Wall ◽  
Left Ventricular

Abstract Background Although dobutamine stress echocardiography (DSE) at the early stage of acute myocardial infarction (AMI) is useful for the prediction of functional and clinical prognosis, the interpretation requires expertise. In this study, we sought to investigate if global longitudinal strain (GLS) during DSE after AMI can predict left ventricular remodeling (LVR). Methods Consecutive 30 patients with anterior wall AMI (18 male, age = 58 ± 13 years) were performed DSE 3 days after AMI. GLS was calculated as an averaged value of peak longitudinal strain in the apical 4- and 2-chamber views at baseline echocardiography, low-dose DSE (10 μg/kg/min) using available software (QLAB, Philips Medical Systems). Left ventricular remodeling (LVR) was defined as an echocardiographically determined increase in both EDVI and ESVI of 20% or more from baseline to the 6 month follow-up echocardiography. Results 12 patients (40%) evolved with LVR. The change in GLS during low-dose DSE was significantly different between the remodeling and non-remodeling group (8 ± 5% v.s. 27 ± 20%, p < 0.05). Interestingly, it predicted LVR with sensitivity of 88%, specificity of 92% at the cut-off value of 12% (Area under the curve = 0.94, p < 0.0001). Conclusion The change in GLS during low-dose DSE can be used as a predictor for the LVR after AMI. This observation has promise for clinical applications. Abstract 1677 Figure.

P6483Predictors of contractile reserve on dobutamine stress echocardiography in patients with classical low-flow, low-gradient aortic stenosis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
V Emer Egypto Rosa ◽  
H B Ribeiro ◽  
R O Samapio ◽  
T C Morais ◽  
M E E Rosa ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Stress Echocardiography ◽  
Dobutamine Stress Echocardiography ◽  
Severe Aortic Stenosis ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Delayed Enhancement ◽  
Low Flow ◽  
Functional Mitral Regurgitation

Abstract Background There is a lack of information on factors that influence contractile reserve (CR) on dobutamine stress echocardiography (DSE) in patients with classical low-flow, low-gradient aortic stenosis (LFLG-AS). Purpose This study sought to evaluate the predictors of CR in patients with LFLG-AS. Methods Prospective study including 43 consecutive LFLG-AS patients (aortic valve area [AVA] ≤1.0 cm2, mean transaortic gradient <40 mmHg, left ventricular ejection fraction [LVEF] <50%) with true severe aortic stenosis. All patients underwent dobutamine stress echocardiography and T1-mapping cardiac magnetic resonance (CMR). CR was defined as an increase ≥20% in the left ventricular stroke volume at peak stress. Patients with pseudo-severe aortic stenosis were excluded. Results All of the patients in the study had degenerative aortic stenosis, with a median age of 67 [60–74] years, most of them being male (83.7%). A high prevalence of comorbidities was found, highlighted by diabetes (42%), hypertension (70%), atrial fibrillation (25%) and coronary artery disease (38%). Mean transaortic gradient was 25 [20–33] mmHg, AVA was 0.88 [0.68–0.95] cm2, LVEF was 35 [28–43]% and 32.6% had moderate/severe functional mitral regurgitation. CMR myocardium extracellular volume fraction (ECV) was 28.8 [26.3–33.0] %, indexed ECV was 35.4 [25.0–41.2] ml/m2, 32.6% had positive transmural delayed-enhancement images and 25.6% had positive mesocardial delayed-enhancement images. On DSE, 30 patients (69.7%) had CR and 13 patients (30.3%) had no CR. Global longitudinal strain was 10 [7–12] %, Δ indexed flow rate was 25 [3–38] ml/m2.seg and Δ mean gradient was 10 [3–16] mmHg. By multivariate analysis, moderate/severe functional mitral regurgitation (HR 0.122, 95% CI 0.020–0.759, p=0.024) and AVA (HR 0.606, 95% CI 0.396–0.925, p=0.020 [for each increase of 0.05 cm2]) were the only factors associated with CR. ECV, indexed ECV and positive transmural or mesocardial delayed-enhancement images were not associated with CR in the univariate analysis. Conclusions In our study, the absence of moderate/severe functional mitral regurgitation and AVA were predictors of CR on DSE in patients with LFLG-AS. As AVA was smaller in patients with CR, our finding contradicts the hypothesis that more severe aortic stenosis could also contribute to the lack of CR. Other possible factors that are surrogate of myocardium fibrosis, as ECV, indexed ECV and positive delayed-enhancement images, were not associated with the absence of CR. Acknowledgement/Funding FAPESP

Unequivocal interpretation of dobutamine stress echocardiography in low‐flow, low‐gradient aortic stenosis by right parasternal view

2021 ◽  
Author(s):  
Martina Setti ◽  
Stefano Nistri ◽  
Andrea Rossi ◽  
Francesca Mantovani ◽  
Flavio L. Ribichini ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Stress Echocardiography ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Low Flow
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