Unit:
Κατεύθυνση Επεμβατική ΚαρδιολογίαLibrary of the School of Health Sciences
Author:
Papagiannakopoulos Vasileios
Supervisors info:
Κυρίτση - Κουκουλάρη Ελένη, Ομότιμη Καθηγήτρια, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Τούτουζας Κωνσταντίνος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Τούσουλης Δημήτριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Μορφολογικές και λειτουργικές αλλαγές της αριστερής κοιλίας σε ασθενείς μετά από TAVI
Translated title:
Morphological and functional changes of the left ventricle after transcatheter aortic valve replacement in patients with severe aortic valve stenosis
Summary:
Background: Aortic valve stenosis is the most common valvular disease, with an incidence that increases with the aging of the population. Chronic pressure overload from a hemodynamically significant aortic valve stenosis causes both an increase in myocardial muscle mass and changes in left ventricular geometry as a compensatory mechanism.
Objective: The purpose of this study is to evaluate the changes in the transthoracic ultrasound imaging of the functionality and hypertrophy of the walls of the left ventricle, as expressed through the interventricular septum-IVS, and the thickness of its posterior wall-PWT, the ejection fraction- LVEF and the end-diastolic diameter of the left ventricle-LVEDd in patients with severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVI).
Methods: The study sample consisted of 251 patients with symptomatic severe aortic valve stenosis and high surgical risk who underwent transcatheter aortic valve replacement (TAVR). Left ventricular ejection fraction-LVEF, left ventricular end-diastolic diameter-LVEDd, interventricular septal thickness-IVS and left ventricular posterior wall thickness-PWT were assessed via transthoracic ultrasound imaging. The above measurements are repeated over time and have been performed: before TAVR surgery, one week after, one month after, six months after and one year after.
Results: From the results of the statistical analysis, it appears that there is a statistically significant decrease in IVS and PWT measurements over time (p-value<0,001), while the changes in LVEF and LVEDd measurements after the operation do not differ statistically significantly compared to before the operation(p-value>0,05). Furthermore, there is a statistically significant negative correlation of LVEF and LVEDd measurements (p-value<0,001), as well as a positive correlation of IVS and PWT measurements(p-value<0,001) between them.
Conclusion: This study shows that left ventricular wall hypertrophy is reversed in patients who underwent percutaneous transcatheter aortic valve replacement. However, both ejection fraction and left ventricular end-diastolic diameter were not statistically significantly different after the operation.
Main subject category:
Health Sciences
Keywords:
Aortic stenosis, TAVI, Ejection fraction, Interventricular septum, Posterior wall thickness, End diastolic diameter
