Effect of aortic valve replacement on myocardial perfusion and exercise capacity in patients with severe aortic stenosis
Rattachement africain : gb, sa, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Abstract Aortic valve replacement (AVR) leads to reverse cardiac remodeling in patients with aortic stenosis (AS). The aim of this secondary pooled analysis was to assess the degree and determinants of changes in myocardial perfusion post AVR, and its link with exercise capacity, in patients with severe AS. A total of 68 patients underwent same-day echocardiography and cardiac magnetic resonance imaging with adenosine stress pre and 6–12 months post-AVR. Of these, 50 had matched perfusion data available (age 67 ± 8 years, 86% male, aortic valve peak velocity 4.38 ± 0.63 m/s, aortic valve area index 0.45 ± 0.13cm2/m2). A subgroup of 34 patients underwent a symptom-limited cardiopulmonary exercise test (CPET) to assess maximal exercise capacity (peak VO2). Baseline and post-AVR parameters were compared and linear regression was used to determine associations between baseline variables and change in myocardial perfusion and exercise capacity. Following AVR, stress myocardial blood flow (MBF) increased from 1.56 ± 0.52 mL/min/g to 1.80 ± 0.62 mL/min/g (p < 0.001), with a corresponding 15% increase in myocardial perfusion reserve (MPR) (2.04 ± 0.57 to 2.34 ± 0.68; p = 0.004). Increasing severity of AS, presence of late gadolinium enhancement, lower baseline stress MBF and MPR were associated with a greater improvement in MPR post-AVR. On multivariable analysis low baseline MPR was independently associated with increased MPR post-AVR. There was no significant change in peak VO2 post-AVR, but a significant increase in exercise duration. Change in MPR was associated with change in peak VO2 post AVR (r = 0.346, p = 0.045). Those with the most impaired stress MBF and MPR at baseline demonstrate the greatest improvements in these parameters following AVR and the magnitude of change in MPR correlated with improvement in peak VO2, the gold standard measure of aerobic exercise capacity.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Effect of aortic valve replacement on myocardial perfusion and exercise capacity in patients with severe aortic stenosis
- Date Crossref
- 14/09/2024
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Glenfield Hospital pays non établi dans la noticeÉtablissement de santé
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NIHR Leicester Cardiovascular Biomedical Research Unit pays non établi dans la noticeOrganisme public
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NIHR Leicester Biomedical Research Centre Department of Cardiovascular Sciences pays non établi dans la noticeStructure de recherche
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University of Leicester pays non établi dans la noticeUniversité ou école supérieure
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King Saud bin Abdulaziz University for Health Sciences pays non établi dans la noticeUniversité ou école supérieure
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Poole Hospital NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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Brigham and Women's Hospital Department of Radiology pays non établi dans la noticeÉtablissement de santé
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Harvard University pays non établi dans la noticeUniversité ou école supérieure
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National Institutes of Health pays non établi dans la noticeOrganisme public
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and Blood Institute Lung pays non établi dans la noticeStructure de recherche
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College of Applied Medical Sciences Department of Cardiovascular Technology - Echocardiography pays non établi dans la noticeUniversité ou école supérieure
Glenfield Hospital, NIHR Leicester Cardiovascular Biomedical Research Unit et Department of Cardiovascular Sciences — NIHR Leicester Biomedical Research Centre, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.