The relative contribution of prosthetic gradients, systemic arterial pressure, and pulse pressure to the left ventricular pressure in patients with aortic prosthetic valves.

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Bech-Hanssen, Odd,1956Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine (author)

The relative contribution of prosthetic gradients, systemic arterial pressure, and pulse pressure to the left ventricular pressure in patients with aortic prosthetic valves.

Article/chapterEnglish2011

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2010-09-02
Oxford University Press (OUP),2011

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LIBRIS-ID:oai:gup.ub.gu.se/130346
https://gup.ub.gu.se/publication/130346URI
https://doi.org/10.1093/ejechocard/jeq101DOI

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Language:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

Notes

AIMS: Aortic valve replacement (AVR) in patients with aortic stenosis reduces the left ventricular (LV) pressure and the LV mass. However, residual LV hypertrophy at follow-up is a common finding with negative prognostic impact. In the present study, we investigate the contribution of the prosthesis (size, type, and gradients) and the load opposed by the arterial system to the mean LV pressure (MLVP). METHODS AND RESULTS: Twenty-five patients with a bileaflet mechanical (n = 12, size 19-27) or stented biological (size 21-25) valve were included. After weaning from bypass, continuous Doppler recordings (transoesophageal transducer) and simultaneous LV and aortic pressure measurements were performed (high-fidelity catheters). The mean prosthesis gradients with catheter or Doppler were moderately correlated to MLVP (R(2) = 0.40 and 0.34, P = 0.002 and <0.0001). In a multiple regression model, the relationship between MLVP and prosthesis gradient, mean blood pressure, and pulse pressure was strong for both mechanical and biological valves. Using catheter prosthesis gradients, we could explain 97% of the variability in MLVP and when using Doppler gradients 91%. CONCLUSION: In the present study of patients with aortic prosthetic valves, we demonstrate the importance of the load opposed by the arterial system for the LV pressure. Our findings suggest that the MLVP can be estimated from easily obtainable Doppler data and blood pressure measurements. In analysing predictors of LV mass regression, morbidity, and mortality following AVR, the equations might be of interest.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
Doppler echocardiography
Aortic prosthetic valves
Left ventricular pressure

Added entries (persons, corporate bodies, meetings, titles ...)

Aljassim, ObaidGothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine(Swepub:gu)xaljob (author)
Houltz, Erik,1951Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care(Swepub:gu)xhouer (author)
Svensson, Gunnar,1951Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine(Swepub:gu)xsvgun (author)
Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin (creator_code:org_t)

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In:European journal of echocardiography: Oxford University Press (OUP)12:1, s. 37-451532-21141525-2167

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