id:"swepub:oai:DiVA.org:umu-127294"
Search: id:"swepub:oai:DiVA.org:umu-127294" > Insights into left ...
- 1 of 1
- Previous record
- Next record
- To hitlist
Insights into left atrial response to pressure and volume overload
-
- Lisi, Matteo, 1982- (author)
- Umeå universitet,Institutionen för folkhälsa och klinisk medicin,Department of Cardiovascular Disease, University of Siena, Italy,,Cardiology
-
- Henein, Michael, Professor (thesis advisor)
- Umeå universitet,Institutionen för folkhälsa och klinisk medicin
-
- Mondillo, Sergio, Professor (thesis advisor)
- Department of Cardiovascular Disease, University of Siena, Italy
- show more...
- show less...
- (creator_code:org_t)
- ISBN 9789176016107
- Umeå : University of Umeå, 2016
- English 138 s.
- Series: Umeå University medical dissertations, 0346-6612 ; 1863
- Doctoral thesis (other academic/artistic)
Abstract
Subject headings
Close
- The general purpose of this thesis is to establish the ability of Speckle Tracking Echocardiography (STE) in assessing left atrial (LA) response to pressure and volume overload respectively in aortic stenosis (AS) and mitral regurgitation (MR), and to evaluate its accuracy in predicting LA and right ventricular (RV) fibrosis in patients with end-stage heart failure (HF) undergoing heart transplantation (HTx).I demonstrated that assessment of left ventricular (LV) long axis systolic velocity and amplitude of excursion is more sensitive than simple determination of ejection fraction (EF) for revealing the beneficial impact of MR surgery on overall LV systolic performance.Severe symptomatic AS is associated with LA enlargement and compromised mechanical function with a high incidence of peri-operative atrial fibrillation (AF). Valve replacement reverses these abnormalities and regains normal atrial function, a behaviour which is directly related to the severity of pre-operative LV outflow tract obstruction. Early identification of LA size and function disturbances, as shown by myocardial strain measurements might contribute to better patient’s recruitment for a safe valve replacement.In late stage HF patients, the right ventricle is enlarged, with reduced systolic function due to significant myocardial fibrosis. RV free wall myocardial deformation is the most accurate function measure that correlates with the extent of RV myocardial fibrosis and functional capacity.In patients with preserved EF, severe MR masks LV and LA myocardial dysfunction and correlates with symptoms and post-operative cavity function instability. Three months after MVR, the underlying myocardial disturbances are unmasked suggesting that most pre-operative measurements are subject to loading conditions. Finally LA volume and PALS remain the main predictors of post-operative AF, thus should be used for stratifying surgical risk.STE has been shown to accurately determine the severity of impairment of LA myocardial function shown by suppressed PALS which was the strongest predictor of the presence and extent of fibrosis, over and above other structure and function parameters. These findings may assist in better stratifying patients with end stage HF and identifying particularly those requiring HTx.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Keywords Mitral regurgitation
- aortic stenosis
- speckle tracking echocardiography
- heart transplantation
- left atrial strain
- left ventricualr function
- right ventricular function
- myocardial fibrosis
Publication and Content Type
- vet (subject category)
- dok (subject category)
Find in a library
- Insights into left atrial response to pressure and volume overload (Search the publication in LIBRIS)
To the university's database
- 1 of 1
- Previous record
- Next record
- To hitlist
Find more in SwePub
- By the author/editor
- Lisi, Matteo, 19 ...
- Henein, Michael, ...
- Mondillo, Sergio ...
- Lars, Lars-Åke, ...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
- MEDICAL AND HEAL ...
- and Clinical Medicin ...
- and Cardiac and Card ...
- Parts in the series
- Umeå University ...
- By the university
- Umeå University
Search outside SwePub
- Extend your search to:
- Google Book Search
- Google Scholar
Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.
- Copyright © LIBRIS - National Library Systems
- LIBRIS.kb.se
