A. Procopi, N. Procopi, JP Collet, O. Barthelemy, P. Leprince, R

Slides:

Advertisements

Similar presentations

Effects of selective heart rate reduction with ivabradine on left ventricular remodelling and function: results from the SHIFT echocardiography substudy.

Advertisements

Trileaflet Aortic Valve. Management strategy for patients with chronic severe aortic regurgitation. Preoperative coronary angiography should be performed.

ACC 2015 Michael J Reardon, MD, FACC On Behalf of the CoreValve US Investigators A Randomized Comparison of Self-expanding Transcatheter and Surgical Aortic.

Asymptomatic Aortic Stenosis and Exercise Test

THE RISE OF NEW TECHNOLOGIES FOR AORTIC VALVE STENOSIS: A PROPENSITY-SCORE ANALYSIS FROM TWO MULTICENTER REGISTRIES COMPARING SUTURELESS AND TRANS-CATHETER.

Ventricular Diastolic Filling and Function

Alsharqia.riyadh Echo meeting Dammam KSA SAYED ABOU EL SOUD MD SBCC.

Cardiac Arrhythmias in Coronary Heart Disease SIGN 94.

CHARM-Preserved: Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity - Preserved Purpose To determine whether the angiotensin.

BEAUTI f UL: morBidity-mortality EvAlUaTion of the I f inhibitor ivabradine in patients with coronary disease and left ventricULar dysfunction Purpose.

Impact of Concomitant Tricuspid Annuloplasty on Tricuspid Regurgitation Right Ventricular Function and Pulmonary Artery Hypertension After Degenerative.

Presenter Disclosure Information John F. Beshai, MD RethinQ Trial Results Disclosures Information: The following relationships exist related to this presentation:

Prosthesis-Patient Mismatch in High Risk Patients with Severe Aortic Stenosis in a Randomized Trial of a Self-Expanding Prosthesis George L. Zorn, III.

TCT 2015 | San Francisco | October 15, 2015 Transcatheter Aortic Valve Replacement for Failed Surgical Bioprostheses Danny Dvir, MD John G. Webb, MD and.

The Impact of Prior Stroke on the Outcome of Patients with Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement Romain Didier, MD;

Left ventricle Michel Slama Amiens France. LV ventricle Ejection fraction Cardiac output Left ventricular filling pressure.

Date of download: 5/29/2016 Copyright © The American College of Cardiology. All rights reserved. From: 2014 AHA/ACC Guideline for the Management of Patients.

Prevalence of preserved left ventricular function among patients admitted for pulmonary oedema F.HAZIZA, N.COHEN, J.F.LANDAU, A.C.GUIOMARD. Service de.

Ten Year Outcome of Coronary Artery Bypass Graft Surgery Versus Medical Therapy in Patients with Ischemic Cardiomyopathy Results of the Surgical Treatment.

Left Ventricular Filling Pressure by Doppler Echocardiography in Patients With End-Stage Renal Disease Angela Y-M Wang, Mei Wang, Christopher W-K Lam,

The Place of Closed Mitral Valvotomy Procedure in Facility Deprived Countries in the Modern PTMC/PMBV Era: 20 Years Experience at SMS Hospital, Jaipur,

Date of download: 7/7/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACC/AHA guidelines for the management of patients.

Impaired RV Global Longitudinal Strain Is Associated With Poor Long-Term Clinical Outcomes in Patients With Acute Inferior STEMI Journal of the American.

Flow-Gradient Patterns in Severe Aortic Stenosis With Preserved Ejection Fraction Clinical Characteristics and Predictors of Survival Mackram F. Eleid,

© free-ppt-templates.com 2017 AHA/ACC Focused Update of Valvular Heart Disease Guideline of 2014 DR. OMAR SHAHID TR CARDIOLOGY SZH.

Longest Follow-up After Implantation of a Self-Expanding Repositionable Transcatheter Aortic Valve: Final Follow-up of the Evolut R CE Study Stephen Brecker,

Outcomes in the CoreValve US High-Risk Pivotal Trial in Patients with a Society of Thoracic Surgeons Predicted Risk of Mortality Less than or Equal to.

Total Occlusion Study of Canada (TOSCA-2) Trial

Pulmonary hypertension in patients with mitral valvular heart disease before and after surgical correction .

Management of mitral regurgitation. See legend for Fig

– р<0.05 between baseline

Preterm birth < 37 weeks

AORTIC STENOSIS.

Transcatheter or Surgical Aortic Valve Replacement in Intermediate Risk Patients with Aortic Stenosis Description: The goal of the trial was to assess.

30-Day Safety and Echocardiographic Outcomes Following Transcatheter Aortic Valve Replacement with the Self-Expanding Repositionable Evolut PRO System.

From: Functional Status and Quality of Life After Transcatheter Aortic Valve ReplacementA Systematic Review Ann Intern Med. 2014;160(4): doi: /M

BACKGROUND AND PURPOSE

Early Outcomes with the Evolut R Repositionable Self-Expanding Transcatheter Aortic Valve in the United States Mathew Williams, MD, For the Evolut R US.

Giuseppe Tarantini MD, PhD

Early Recovery of Left Ventricular Systolic Function After CoreValve Transcatheter Aortic Valve Replacement Harold L. Dauerman, MD; Michael J. Reardon,

Management strategy for patients with aortic stenosis

Echocardiographic modalities for evaluation and risk stratification of heart failure patients. 3D indicates 3-dimensional; EF, ejection fraction; LA, left.

Influence of Afterload on Global and Basal Longitudinal Strain: Comparison of Blood Pressure and Wall Stress Upasana Jarori, M. Waqas Choudhry, Shujaur.

University Heart Center Hamburg

The 28th Great Wall International Congress of Cardiology

Kuznetsov VA, Soldatova AM, Krinochkin DV, Enina TN

by Alexander Kulik, Ian G. Burwash, Varun Kapila, Thierry G

Circ Cardiovasc Imaging

Nat. Rev. Cardiol. doi: /nrcardio

Samir R. Kapadia, MD On behalf of The PARTNER Trial Investigators

Figure 2 Echocardiographic methods to estimate left atrial pressure

Figure 6 Speckle tracking echocardiography to

Johannes Steiner et al. JACC 2017;70:

Johannes Steiner et al. JACC 2017;70:

Figure 2 A patient with aortic stenosis and mitral regurgitation

Nat. Rev. Cardiol. doi: /nrcardio

Nat. Rev. Cardiol. doi: /nrcardio

Five-Year Outcomes after Randomization to Transcatheter or Surgical Aortic Valve Replacement: Final Results of The PARTNER 1 Trial Michael J. Mack, MD.

Ao, aorta; CEOA, corrected effective orifice area; CFD, color-flow Doppler; CW, continuous-wave; DBP, diastolic blood pressure; LV EDP, left ventricular.

Impact of Preoperative Symptoms on Postoperative Survival in Severe Aortic Stenosis: Implications for the Timing of Surgery Sophie Piérard, MD, Christophe.

Correlation between endothelial function and hypertension

Slides courtesy of Dr. Randall Harada

Marie-Annick Clavel et al. JIMG 2017;10:

Procedural Characteristics

Rick A. Nishimura et al. JACC 2014;63:e57-e185

Fernanda M. Mangione et al. JIMG 2017;10:82-85

Rick A. Nishimura et al. JACC 2017;70:

KM analysis of 1-year mortality in the study population stratified according to different baseline characteristics. KM analysis of 1-year mortality in.

David H. Harpole, MD, Stanley A. Gall, MD, Walter G. Wolfe, MD, J

Transcatheter versus medical treatment of symptomatic severe tricuspid regurgitation: a propensity score matched analysis Maurizio Taramasso MD, PhD from.

Presentation transcript:

Acute left ventricular mechanics changes after TAVR: the afterload concept revisited A.Procopi, N.Procopi, JP Collet, O. Barthelemy, P. Leprince, R.Choussat, R.Isnard Institut de Cardiologie - Pitié-Salpêtrière University Hospital, APHP, Paris, France Only 9/35 (26 %) had a LVEF ≤ 60%. Overall, no significant change in LVEF (65 ± 14%; p = 0.55) or GLS (-16.1 ± 4.8%; p = 0.11) occurred immediately after TAVR despite a dramatic decrease in transaortic mean pressure gradient (44 ± 15 mm Hg versus 6 ± 3 mmHg; p < 0.0001). However in the subgroup of patients with LVEF ≤ 60%, a significant increase in GLS after TAVR was observed (-9.6 ± 4.1 % versus -12.1 ± 3.3 %; p= 0.0039). Background Echocardiographic parameters before and after TAVR Recent studies have emphasized the prognostic value of mild left ventricular ejection fraction (LVEF) impairment in severe aortic stenosis. However, despite adaptive mechanisms to pressure overload, subtle impaired systolic function could be worsened by increased afterload and partly reversible immediately after its correction. N = 35 patients Before After p LVEF (%) 66 ± 13 65 ± 14 0,55 GLS (- %) 15,1 ± 4,7 16,1 ± 4,8 0,11 Orifice valve area (cm²) 0,7 ± 0,2 2,2 ± 0,7 < 0,001 Transaortic mean pressure gradient (mmHg) 44 ± 15 6 ± 3 Baseline characteristics (N = 35 patients) Age 85 ± 5 years Male 18 (51%) NYHA I 1 (3%) II 16 (46%) III Angina 7 (20%) Syncope 3 (9%) Heart failure 10 (29%) Atrial fibrillation Coronary artery disease Euroscore II 3,8 ± 3,1 LVEF (%) 66 ± 13 LVEF ≤ 60% 9 (26%) Beta blockers 15 (43%) ACE/ARB 24 (69%) Objectives The aim was to evaluate the short terms effects of transcatheter aortic valve replacement (TAVR) on LV systolic function assessed by global longitudinal strain (GLS). We hypothesized that abrupt decrease of LV afterload after TAVR could lead to immediate improvement of LV systolic function. Improvement in GLS according to the LVEF Methods Patients referred to our Department for TAVR were included from January to July 2018 in this observational prospective single center study. Transthoracic echocardiography (TTE) was performed immediately before and 1-5 days after TAVR by the same operator and blindly reviewed. Results Conclusion 35 symptomatic patients with severe aortic stenosis referred for TAVR (mean age 84 ± 5 y, 18 male, NYHA 2-3, orifice area 0.7 ± 0.2 cm², LVEF 66 ± 13 % , GLS - 15.1 ± 4.7 %) were included. Following TAVR, an early improvement in LV systolic function assessed by GLS was observed only in patients with pre-existing mild LV systolic dysfunction. Further studies should evaluate whether this improvement is associated with better long term outcome