3 research outputs found
Early detection of left ventricular diastolic dysfunction using conventional and speckle tracking echocardiography in a large animal model of metabolic dysfunction
Left ventricular (LV) diastolic dysfunction is one of the important
mechanisms responsible for symptoms in patients with heart failure. The
aim of the current study was to identify parameters that may be used to
detect early signs of LV diastolic dysfunction in diabetic pigs on a
high fat diet, using conventional and speckle tracking echocardiography.
The study population consisted of 16 healthy Göttingen minipigs and 18
minipigs with experimentally induced metabolic dysfunction.
Echocardiography measurements were performed at baseline and 3-month
follow-up. The ratio of peak early (E) and late filling velocity (E/A
ratio) and the ratio of E and the velocity of the mitral annulus early
diastolic wave (E/Em ratio) did not change significantly in both groups.
Peak untwisting velocity decreased in the metabolic dysfunction group
(− 30.1 ± 18.5 vs. − 23.4 ± 15.5 °/ms) but not in controls
(− 38.1 ± 23.6 vs. − 42.2 ± 23.0 °/ms), being significantly different
between the groups at the 3-month time point (p < 0.05). In
conclusion, whereas E/A ratio and E/Em ratio did not change
significantly after 3Â months of metabolic dysfunction, peak untwisting
velocity was significantly decreased. Hence, peak untwisting velocity
may serve as an important marker to detect early changes of LV diastolic
dysfunction.</p
Early detection of left ventricular diastolic dysfunction using conventional and speckle tracking echocardiography in a large animal model of metabolic dysfunction
Transcatheter Aortic Valve Replacement for Pure Native Aortic Valve Regurgitation:The PANTHEON International Project
Background: Transcatheter aortic valve replacement (TAVR) in patients with pure severe native aortic valve regurgitation (NAVR) has been associated with suboptimal results. The available evidence concerns mostly outdated transcatheter heart valves (THVs). Objectives: The aim of this study was to investigate the performance of new-generation THVs in patients treated for pure severe NAVR. Methods: The PANTHEON (Performance of Currently Available Transcatheter Aortic Valve Platforms in Inoperable Patients With Pure Aortic Regurgitation of a Native Valve) study retrospectively included patients who underwent TAVR with currently available devices (both self-expanding [SE] and balloon expandable [BE]) for severe NAVR. Technical and device success rates as well as a composite of all-cause mortality and heart failure rehospitalization at 1 year were evaluated. The rate and clinical consequences of acute transcatheter valve embolization or migration (TVEM) were also considered. Results: A total of 201 patients were included. Overall technical and device success rates were 83.6% and 76.1%, respectively, and did not differ between SE and BE devices. These figures were due mostly to TVEM occurrence (14.6% vs 16.1%; P = 0.47) and residual moderate or greater aortic regurgitation (9.2% vs 10.1%; P = 0.87). Patients who experienced TVEM compared with those without TVEM had a significantly higher incidence of the composite endpoint at 1 year (25.7% vs 15.8%; P = 0.05). Conclusions: Despite improved THV platforms and techniques, TAVR for pure severe NAVR remains a challenging procedure, with significant risk for TVEM. SE and BE platforms demonstrated comparable performance in this setting.</p