The shape of the aortic outflow velocity profile revisited. Is there a relation to contractile function in coronary artery disease? An automated analysis using mathematical modeling (CROSBI ID 547827)
Prilog sa skupa u časopisu | sažetak izlaganja sa skupa | međunarodna recenzija
Podaci o odgovornosti
Čikeš, Maja ; Kalinić, Hrvoje ; Baltabaeva, Aigul ; Lončarić, Sven ; Parsai, Chirine ; Miličić, Davor ; Čikeš, Ivo ; Sutherland, George R. ; Bijnens, Bart
engleski
The shape of the aortic outflow velocity profile revisited. Is there a relation to contractile function in coronary artery disease? An automated analysis using mathematical modeling
Myocardium contracts in the beginning of ejection causing outflow acceleration, resulting in asymmetric velocity profiles peaking around 1/3 of ejection and declining when force development declines. We hypothesized that decreased contractility in coronary artery disease (CAD) might change outflow timing and shape. 79 patients undergoing routine full dose dobutamine stress-echo (DSE) were divided into 2 groups based on resting wall-motion and DSE-response: CAD negative (CADneg) (35/79) and positive (CADpos) (44/79) which were compared to 32 healthy volunteers. Aortic CW-Doppler traces at rest were analyzed semi-automatically ; time-to-peak (Tmod), ejection-time (ETmod), rise- (trise) and fall-time (tfall) were quantified. Asymmetry (asymm) was calculated as the normalized difference of left and right half of the spectrum. Normal curves were triangular, early-peaking, while patients showed more rounded shapes and later peaks. Tmod was significantly increased in CADpos. Tmod/ETmod was significantly longer in CADpos, compared to controls and shortest in CADneg. Trise was longest in CADpos. Tfall was shortest in CADpos, followed by controls and CADneg. Asymm was lowest in CADpos, followed by controls and CADneg. Abnormally symmetric profiles (asymm<0.25) were found in none of the controls, 2.9% CADneg and 27.3% CADpos. A good correlation was found between assym and ejection fraction (EF) and Tmod/ETmod and EF. Notably, an LV dynamic gradient was induced in 71.4% CADneg and in 18.2% CADpos, associated with LV hypertrophy and supernormal (very asymmetric) traces. Decreased contractility results in a more symmetrical outflow, while very asymmetrical traces suggest increased contractility, potentially inducing intra-cavity gradients during DSE.
left ventricular outflow; doppler echocardiography; coronary artery disease
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Podaci o prilogu
60-60.
2008.
nije evidentirano
objavljeno
Podaci o matičnoj publikaciji
Liječnički vjesnik : glasilo Hrvatskoga liječničkog zbora
Miličić, Davor ; Čikeš, Maja
Zagreb: Hrvatski liječnički zbor
0024-3477
Podaci o skupu
Congress of the Croatian Cardiac Society with International Participation (7 ; 2008)
predavanje
16.10.2008-19.10.2008
Opatija, Hrvatska