Key result
Adding sphericity index to LVDD improves prediction of late systolic dysfunction in aortic regurgitation.
Why the study?
Increased LV diastolic diameter and decreased ejection fraction may be observed only after irreversible myocardial damage has occurred in aortic valve insufficiency, motivating evaluation of whether changes in LV geometry can predict systolic dysfunction in experimental aortic regurgitation.
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Combined indices may refine progression monitoring in experimental AR; leaves open translation to human risk stratification.
Although an increased left ventricular (LV) diastolic diameter (DD) and a decreased ejection fraction have been used as markers for the surgical replacement of an insufficient aortic valve, these signals may be observed when irreversible myocardium damage has already occurred. The aim of this study was to determine whether change in LV geometry predicts systolic dysfunction in experimental aortic regurgitation. Male Wistar rats underwent surgical acute aorta regurgitation (aorta regurgitation group; n = 23) or a sham operation (sham group; n = 12). After the procedure, serial transthoracic echocardiograms were performed at 1, 4, 8, and 16 wk. At the end of protocol, the LV, lungs, and liver were dissected and weighed. During the follow-up, no animal developed overt heart failure. There was a correlation between the LV sphericity index and reduced fractional shortening (P < 0.001) over time. A multiple regression model showed that the LVDD-sphericity index association at 8 wk was a better predictor of decreased fractional shortening at week 16 (R(2) = 0.50; P < 0.001) than was the LVDD alone (R(2) = 0.39; P = 0.001). LV geometry associated with increased LVDD improved the prediction of systolic dysfunction in experimental aortic regurgitation.
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Roscani et al. (2014) studied Experimental aortic regurgitation (n=35). Surgical acute aorta regurgitation and LVDD-sphericity index evaluation vs. Sham operation / LVDD alone was evaluated on Prediction of decreased fractional shortening (systolic dysfunction) at week 16 (R2 0.50, p=<0.001). Combining LVDD and sphericity index at 8 weeks better predicted decreased fractional shortening at 16 weeks (R2=0.50; P<0.001) than LVDD alone (R2=0.39; P=0.001) in rats with aortic regurgitation.
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