dc.contributor.author
Nordmeyer, Sarah
dc.contributor.author
Lee, Chong Bin
dc.contributor.author
Goubergrits, Leonid
dc.contributor.author
Knosalla, Christoph
dc.contributor.author
Berger, Felix
dc.contributor.author
Falk, Volkmar
dc.contributor.author
Ghorbani, N.
dc.contributor.author
Hireche-Chikaoui, H.
dc.contributor.author
Zhu, Miry
dc.contributor.author
Kelle, Sebastian
dc.contributor.author
Kuehne, Titus
dc.contributor.author
Kelm, Marcus
dc.date.accessioned
2023-03-13T12:08:33Z
dc.date.available
2023-03-13T12:08:33Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/38338
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-38057
dc.description.abstract
Background: Circulatory efficiency reflects the ratio between total left ventricular work and the work required for maintaining cardiovascular circulation. The effect of severe aortic valve stenosis (AS) and aortic valve replacement (AVR) on left ventricular/circulatory mechanical power and efficiency is not yet fully understood. We aimed to quantify left ventricular (LV) efficiency in patients with severe AS before and after surgical AVR.
Methods: Circulatory efficiency was computed from cardiovascular magnetic resonance (CMR) imaging derived volumetric data, echocardiographic and clinical data in patients with severe AS (n = 41) before and 4 months after AVR and in age and sex-matched healthy subjects (n = 10).
Results: In patients with AS circulatory efficiency was significantly decreased compared to healthy subjects (9 +/- 3% vs 12 +/- 2%; p = 0.004). There were significant negative correlations between circulatory efficiency and LV myocardial mass (r = - 0.591, p < 0.001), myocardial fibrosis volume (r = - 0.427, p = 0.015), end systolic volume (r = - 0.609, p < 0.001) and NT-proBNP (r = - 0.444, p = 0.009) and significant positive correlation between circulatory efficiency and LV ejection fraction (r = 0.704, p < 0.001). After AVR, circulatory efficiency increased significantly in the total cohort (9 +/- 3 vs 13 +/- 5%; p < 0.001). However, in 10/41 (24%) patients, circulatory efficiency remained below 10% after AVR and, thus, did not restore to normal values. These patients also showed less reduction in myocardial fibrosis volume compared to patients with restored circulatory efficiency after AVR.
Conclusion: In our cohort, circulatory efficiency is reduced in patients with severe AS. In 76% of cases, AVR leads to normalization of circulatory efficiency. However, in 24% of patients, circulatory efficiency remained below normal values even after successful AVR. In these patients also less regression of myocardial fibrosis volume was seen. Trial Registration clinicaltrials.gov NCT03172338, June 1, 2017, retrospectively registered.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Circulatory efficiency
en
dc.subject
Aortic valve stenosis
en
dc.subject
Heart failure
en
dc.subject
Aortic valve replacement
en
dc.subject
Hemodynamics
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Circulatory efficiency in patients with severe aortic valve stenosis before and after aortic valve replacement
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
15
dcterms.bibliographicCitation.doi
10.1186/s12968-020-00686-0
dcterms.bibliographicCitation.journaltitle
Journal of Cardiovascular Magnetic Resonance
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.volume
23
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.funding
Springer Nature DEAL
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
33641670
dcterms.isPartOf.eissn
1532-429X