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Background: Aortic stenosis (AS) is increasingly diagnosed in current aging society. Echocardiography is the most important tool in the assessment of AS and its severity. However, load-dependency of Doppler measurement could affect the accuracy of AS severity assessment. We tried to evaluate the impact of afterload on the assessment of AS severity by modification of afterload using pneumatic compression (Pcom).

Methods: Forty patients diagnosed as moderate or severe AS [effective orifice area of aortic valve (EOAAV) by continuity equation of < 1.5 cm2] were consecutively enrolled. Patients with severely uncontrolled hypertension, severe left ventricular (LV)dysfunction, and other significant valve disease were excluded. Comprehensive echocardiography was performed at baseline to assess AS severity. Then, pneumatic compression of the lower extremities by 100 mmHg was applied to increase LV afterload. After 3 minutes, echocardiography was repeated to assess AS severity.

Results: Mean blood pressure was significantly increased under Pcom (p < 0.001), while heart rate remained unchanged. Peak aortic valve velocity (Vmax) was slightly, but significantly decreased under Pcom (p = 0.03). However, Doppler velocity index and EOAAV by continuity equation were not affected by Pcom.

Conclusion: AS severity assessment by echocardiography was not dependent on the change of LV afterload imposed by Pcom. AV Vmax was slightly decreased with LV afterload increment, but these changes were too small to alter treatment plan of AS patients. EOAAV and Doppler velocity index are more stable parameters for AS severity assessment.

권호기사

권호기사 목록 테이블로 기사명, 저자명, 페이지, 원문, 기사목차 순으로 되어있습니다.
기사명 저자명 페이지 원문 목차
Assessment of Mitral Valve Complex by Three-Dimensional Echocardiography : Therapeutic Strategy for Functional Mitral Regurgitation Kiyoshi Yoshida, Kikuko Obase pp.69-76

Problem Is in the Subclinical Afterload Mismatch 최의영 pp.77-78

Impact of Afterload on the Assessment of Severity of Aortic Stenosis 장성아, 김형관, 손대원 pp.79-84

Atrioventricular Flow Wave Patterns before and after Birth by Fetal Echocardiography 김한울, 이효연, 백수진, 홍영미 pp.85-89

Impact of Arterial Stiffness on Regional Myocardial Function Assessed by Speckle Tracking Echocardiography in Patients with Hypertension 황정원, 강수진, 임홍석, 최병주, 최소연, 황교승, 윤명호, 신준한, 탁승제 pp.90-96

A Case of an Anomalous Hypertrophied Muscle Band in the Left Ventricle 이상혁, 류현민, 이주환, 이현상, 박선희, 배명환, 양동헌 pp.97-99

Perforated Mitral Valve Aneurysm in the Posterior Leaflet without Infective Endocarditis 김동준, 조경임, 전희재, 김유정, 송여정, 지준형, 천민구, 김성만, 이현국, 김태익 pp.100-102

Isolated Left Ventricular Noncompaction with a Congenital Aneurysm Presenting with Recurrent Embolism 안종화, 고진신, 박정랑, 박미정, 민지현, 조상영, 이은주, 김완철, 김계환 pp.103-107

Multiple Fistula Emptying into the Left Ventricle through the Entire Left Ventricular Wall 이동엽, 박선희, 배명환, 이장훈, 양동헌, 박헌식, 조용근, 채성철, 전재은 pp.108-111

Spot Diagnosis Using Pulse Wave Doppler Interrogation of the Abdominal Aorta Karima Addetia, Judith Therrien pp.112-113

Membranous Ventricular Septum Aneurysm as a Cause of Recurrent Transient Ischemic Attack Damir Fabijanic, Cristijan Bulat, Tonci Batinic, Vedran Carevic, Kresimir Caljkusic pp.114-115

참고문헌 (15건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 Epidemiology and cardiovascular risk factors of aortic stenosis. 네이버 미소장
2 Prevalence of aortic valve abnormalities in the elderly: An echocardiographic study of a random population sample 네이버 미소장
3 Chambers J. Can high blood pressure mask severe aortic stenosis? J Heart Valve Dis 1999;8:277-8. 미소장
4 Paradoxical low-flow, low-gradient severe aortic stenosis despite preserved ejection fraction is associated with higher afterload and reduced survival. 네이버 미소장
5 Symptomatic Aortic Stenosis 네이버 미소장
6 Impact of loading condition on the 2D speckle tracking-derived left ventricular dyssynchrony index in nonischemic dilated cardiomyopathy. 네이버 미소장
7 Determination of the stenotic aortic valve area in adults using Doppler echocardiography 네이버 미소장
8 Determination of cardiac output by Doppler echocardiography. 네이버 미소장
9 Systemic pressure does not directly affect pressure gradient and valve area estimates in aortic stenosis in vitro 네이버 미소장
10 The mechanism of opening of the aortic valve. 네이버 미소장
11 Regulation of the aortic valve opening: In vivo dynamic measurement of aortic valve orifice area 네이버 미소장
12 Impact of blood pressure on the Doppler echocardiographic assessment of severity of aortic stenosis. 네이버 미소장
13 Effects of pneumatic antishock garment inflation in normovolemic subjects 네이버 미소장
14 Noninvasive measurement of systemic vascular resistance using Doppler echocardiography. 네이버 미소장
15 Total arterial compliance estimated by stroke volume-to-aortic pulse pressure ratio in humans. 네이버 미소장

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