title: Improvement in left ventricular function assessed by tissue Doppler imaging after aortic valve replacement for severe aortic stenosis.
abstract: BACKGROUND
  The effects of reduction of left ventricular (LV) systemic afterload following aortic valve replacement (AVR) for severe aortic valve stenosis (AS) were investigated, using echocardiography and tissue Doppler imaging (TDI).
  
  
  METHODS
  We compared the preoperative and postoperative echocardiographic assessments of 23 patients with severe AS who had undergone isolated AVR (n = 13) or concomitant AVR with coronary artery bypass grafting (CABG) (n = 10). Conventional echocardiographic evaluations and TDI at the lateral mitral annulus were performed.
  
  
  RESULTS
  Echocardiography was performed at a median of 120 (interquartile range: 66-141) days after AVR. There was significant reduction in aortic transvalvular mean pressure gradient after AVR. Although LV dimensions, mass and ejection fraction remained unchanged, LV diastolic and systolic functions improved (as observed on TDI). Early diastolic (E'), late diastolic (A') and systolic (S') mitral annular velocities increased significantly (p < 0.05). There was significant improvement in TDI-derived parameters among the patients who had isolated AVR, while among the patients who had concomitant AVR with CABG, only S' had significant improvement (p = 0.028).
  
  
  CONCLUSIONS
  TDI was able to detect improvements in LV systolic and diastolic function after AVR for severe AS. There was less improvement in the TDI-derived diastolic parameters among patients who underwent concomitant AVR with CABG than among patients who underwent isolated AVR.
authors.affiliation: Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore.
authors.forename: Chih-Chiang
authors.initials: CC
authors.lastname: Nieh
authors.affiliation: Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore.
authors.forename: Alvin Yeng-Hok
authors.initials: AY
authors.lastname: Teo
authors.affiliation: Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore.
authors.forename: Wern Miin
authors.initials: WM
authors.lastname: Soo
authors.affiliation: Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore.
authors.forename: Glenn K
authors.initials: GK
authors.lastname: Lee
authors.affiliation: Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore.
authors.forename: Devinder
authors.initials: D
authors.lastname: Singh
authors.affiliation: Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore ; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Kian-Keong
authors.initials: KK
authors.lastname: Poh
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D001026:Coronary Artery Bypass; D003971:Diastole; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013599:Systole; D016277:Ventricular Function, Left
keywords: aortic valve replacement; aortic valve stenosis; coronary artery bypass grafting; left ventricular function; tissue Doppler imaging