Improvement of Ultrasonic Myocardial Properties after Aortic Valve Replacement for Pure Severe Aortic Stenosis: The Predictive Value of Ultrasonic Tissue Characterization for Left Ventricle Reverse Remodeling

Fijalkowski, Marcin; Koprowski, Andrzej; Galaska, Rafal; Gruchala, Marcin; Pawlaczyk, Rafal; Brzezinski, Maciej; Rogowski, Jan; Rynkiewicz, Andrzej

doi:10.1016/j.echo.2010.07.018

« Previous Next »Journal of the American Society of Echocardiography
Volume 23, Issue 10 , Pages 1060-1066, October 2010

Improvement of Ultrasonic Myocardial Properties after Aortic Valve Replacement for Pure Severe Aortic Stenosis: The Predictive Value of Ultrasonic Tissue Characterization for Left Ventricle Reverse Remodeling

Marcin Fijalkowski, MD, PhD
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
- Address reprint requests to Marcin Fijalkowski, MD, PhD, Medical University of Gdansk, First Department of Cardiology, ul Debinki 7, 80-211 Gdansk, Poland.
Andrzej Koprowski, MD, PhD
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
Rafal Galaska, MD, PhD
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
Marcin Gruchala, MD, PhD
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
Rafal Pawlaczyk, MD, PhD
- Cardiosurgery Department, Medical University of Gdansk, Gdansk, Poland
Maciej Brzezinski, MD, PhD
- Cardiosurgery Department, Medical University of Gdansk, Gdansk, Poland
Jan Rogowski, MD, PhD
- Cardiosurgery Department, Medical University of Gdansk, Gdansk, Poland
Andrzej Rynkiewicz, MD, PhD, FESC, FACC
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland

published online 02 September 2010.

Background

Aortic stenosis leads to left ventricular hypertrophy and accumulation of fibrillar collagens. The analysis of integrated backscatter (IBS) parameters provides information on ultrasonic myocardial properties.

Methods

The study population consisted of 58 patients with aortic stenosis. They were followed up for an average 18 ± 5 months after aortic valve replacement (AVR). Traditional transthoracic echocardiography and analysis of IBS reflectivity were performed before AVR and during the control visit after AVR.

Results

A significant reduction in left ventricular mass index, a significant increase in the mean cyclic variation of IBS, and a decrease in absolute end-diastolic IBS intensity were observed after AVR.

Conclusions

These data suggest improvements in ultrasonic myocardial properties after AVR. Preoperative analysis of IBS parameters might provide additional information for predicting left ventricular reverse remodeling in patients a mean of 1.5 years after AVR for aortic stenosis.

Keywords: Aortic stenosis, Ultrasonic tissue characterization, Left ventricular reverse remodeling

Abbreviations: AS, Aortic stenosis, AVA, Aortic valve area, AVR, Aortic valve replacement, cESS, Circumferential end-systolic wall stress, CVIBS, Cyclic variation of integrated backscatter, CVIBS_index, Index of cyclic variation of integrated backscatter, EF, Ejection fraction, EOA, Effective orifice area, FS, Fractional shortening, IBS, Integrated backscatter, IBS_ed, Integrated backscatter at end-diastole, IBS_es, Integrated backscatter at end-systole, LV, Left ventricular, LVM, Left ventricular mass, LVMI, Left ventricular mass index, LVOT, Left ventricular outflow tract, mwFS, Midwall fractional shortening, PG, Pressure gradient, PPM, Patient-prosthesis mismatch, ROC, Receiver operating characteristic, RWT, Relative wall thickness, VTI, Velocity-time integral