Reduced atrial emptying after orthotopic heart transplantation masquerading as restrictive transmitral Doppler flow pattern?

Détails

ID Serval
serval:BIB_9B646E10A94B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Reduced atrial emptying after orthotopic heart transplantation masquerading as restrictive transmitral Doppler flow pattern?
Périodique
Echocardiography
Auteur(s)
Pascale P., Monney P., Jeanrenaud X., Aebischer N., Yerly P., Vogt P., Pruvot E., Schläpfer J.
ISSN
1540-8175 (Electronic)
ISSN-L
0742-2822
Statut éditorial
Publié
Date de publication
2011
Volume
28
Numéro
2
Pages
168-174
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
BACKGROUND: An elevated early (E) to late (A) diastolic filling velocities ratio, typically seen in advanced diastolic dysfunction, has also been observed after cardioversion of atrial fibrillation as a consequence of the depressed left atrial (LA) contractility. We hypothesized that the impaired LA contractile function demonstrated after orthotopic cardiac transplantation (OCT) could also lead to this "pseudorestrictive" pattern.
METHOD: E/A ratio related to the tissue Doppler early mitral annular velocity (Ea) as preload-independent index of LV relaxation was evaluated in all consecutive OCT patients between 2005 and 2007.
RESULTS: The study population comprised 48 patients 97 ± 77 months after OCT. Thirty-two patients (67%) had an E/A ratio > 2. LV systolic function and myocardial relaxation assessed by the Ea velocity were similar compared to patients with normal ratio (61 ± 6% vs. 60 ± 12%, P = 0.854 and 15 ± 4 cm/s vs. 14 ± 3 cm/s, r = 0.15, P = 0.323, respectively). On the other hand, the proportion of the recipient and donor LA cuffs as estimated by the recipient/global LA area ratio and the LA emptying fraction significantly correlated with the E/A ratio (r = 0.40, P = 0.005 and r =-0.33, P = 0.022, respectively).
CONCLUSION: Our study shows that there is a high prevalence of elevated E/A ratio after standard OCT which seems mainly related to reduced LA contractility. Recognition of this "pseudorestrictive" pattern may avoid misdiagnosis of diastolic dysfunction.
Mots-clé
Diagnosis, Differential, Echocardiography, Doppler/methods, Female, Heart Atria/ultrasonography, Heart Transplantation/adverse effects, Heart Transplantation/ultrasonography, Humans, Male, Middle Aged, Mitral Valve Stenosis/etiology, Mitral Valve Stenosis/ultrasonography, Reproducibility of Results, Sensitivity and Specificity
Pubmed
Web of science
Création de la notice
22/02/2011 8:02
Dernière modification de la notice
20/08/2019 15:02
Données d'usage