Preoperative Longitudinal Left Ventricular Function by Tissue Doppler Echocardiography at Rest and During Exercise Is Valuable in Timing of Aortic Valve Surgery in Male Aortic Regurgitation Patients
Background
The aim of this study was to evaluate if left ventricular (LV) systolic function by tissue Doppler echocardiography at rest and during exercise preoperatively could predict postoperative LV function and thereby be useful in the timing of aortic valve surgery in patients with severe aortic regurgitation.
Methods
In 29 patients (median age, 59 years; interquartile range, 39-64 years), echocardiography, tissue Doppler echocardiography, and radionuclide ventriculography were performed preoperatively and postoperatively at rest and during supine bicycle exercise.
Results
Preoperative ejection fraction (EF) was 62%. Patients formed two groups, with basal LV peak systolic velocity (PSV) 5.9 cm/s preoperatively as the cutoff value between low and high PSV. Preoperatively, patients with low PSV had lower PSV during exercise (P < .005), EF during exercise (P < .05), and atrioventricular plane displacement (AVPD) at rest (P < .005) and during exercise (P < .05) than those with high PSV. Postoperatively, patients with low PSV had smaller AVPD at rest (P < .05), AVPD during exercise (P < .01), and PSV during exercise (P < .01).
Conclusion
In patients with chronic aortic regurgitation with EFs and LV dimensions not fulfilling criteria for surgery according to guidelines, preoperative PSV and AVPD at rest and during exercise detected postoperative LV dysfunction.
aDepartment of Clinical Physiology, Heart Centre in Östergötland, University Hospital and Department of Medical and Health Sciences, University of Linköping, Linköping, Sweden
bDepartment of Cardiothoracic Surgery, Heart Centre in Östergötland, University Hospital and Department of Medical and Health Sciences, University of Linköping, Linköping, Sweden
Reprint requests: Lena Helin, University Hospital Linköping, Department of Clinical Physiology, SE 581 85 Linköping, Sweden.
ABSTRACT