Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

The shape of the aortic outflow velocity profile revisited: is there a relation between its asymmetry and ventricular function in coronary artery disease?

Čikeš, Maja and Kalinić, Hrvoje and Baltabaeva, Aigul and Lončarić, Sven and Parsai, Chirine and Miličić, Davor and Čikeš, Ivo and Sutherland, George and Bijnens, Bart (2009) The shape of the aortic outflow velocity profile revisited: is there a relation between its asymmetry and ventricular function in coronary artery disease? European journal of echocardiography, [Epub . ISSN 1525-2167

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    English abstract

    AIMS: Myocardium contracts in the beginning of ejection causing outflow acceleration, resulting in asymmetric outflow velocity profiles peaking around one-third of ejection and declining when force development declines. This article aimed to demonstrate that decreased contractility in coronary artery disease (CAD) changes outflow timing and profile symmetry. METHODS AND RESULTS: Seventy-nine patients undergoing routine full dose dobutamine stress-echo (DSE) were divided into two groups based on resting wall motion and DSE response: DSE negative (DSE(neg)) (35 of 79 patients) and positive (DSE(pos)) (44 of 79 patients) which were compared with 32 healthy volunteers. Aortic CW-Doppler traces at rest were analysed semi-automatically; time-to-peak (T(mod)), ejection-time (ET(mod)), rise-time (t(rise)), and fall-time (t(fall)) were quantified. Asymmetry (asymm) was calculated as the normalized difference of left and right half of the spectrum. Normal curves were triangular, early-peaking, whereas patients showed more rounded shapes and later peaks. T(rise) was longest in DSE(pos). T(fall) was shortest in DSE(pos), followed by controls and DSE(neg). Asymm was lowest in DSE(pos), followed by controls and DSE(neg). Abnormally symmetric profiles (asymm <0.25) were found in none of the controls, 2.9% DSE(neg), and 27.3% DSE(pos). A good correlation was found between assym and ejection fraction (EF) and T(mod)/ET(mod) and EF. Notably, an LV dynamic gradient was induced in 71.4% DSE(neg) and in 18.2% DSE(pos), associated with LV hypertrophy and supernormal (very asymmetric) traces. CONCLUSION: Decreased myocardial function results in a more symmetrical outflow, while very asymmetrical traces suggest increased contractility, potentially inducing intra-cavity gradients during DSE. Therefore, including outflow symmetry as a clinical measurement provides additional information on patients with CAD.

    Item Type: Article
    Divisions: Katedra za internu medicinu
    Depositing User: Marijan Šember
    Status: Published
    Creators:
    CreatorsEmail
    Čikeš, Maja
    Kalinić, Hrvoje
    Baltabaeva, Aigul
    Lončarić, Sven
    Parsai, Chirine
    Miličić, Davor
    Čikeš, Ivo
    Sutherland, George
    Bijnens, Bart
    Date: 16 June 2009
    Date Deposited: 04 Sep 2009
    Last Modified: 23 Sep 2011 18:11
    Subjects: /
    Related URLs:
      URI: http://medlib.mef.hr/id/eprint/656

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