https://scholars.lib.ntu.edu.tw/handle/123456789/636143
標題: | Quantification of cardiac pumping mechanics in TAVI patients: A pilot study utilizing minimally invasive method for pressure-volume analysis | 作者: | Tsung-Yu Ko Chuang, Chia-Chuan MAO-SHIN LIN Chen, Yi-Chang YING-HSIEN CHEN CHING-CHANG HUANG CHIH-FAN YEH MING-JIUH WANG KUO-CHU CHANG YI-LWUN HO HSIEN-LI KAO |
關鍵字: | aortic stenosis; pressure-volume analysis; transcatheter aortic valve implantation; ventriculo-arterial coupling | 公開日期: | 九月-2023 | 卷: | 11 | 期: | 17 | 起(迄)頁: | e15799 | 來源出版物: | Physiological reports | 摘要: | The ventriculo-arterial coupling (VAC) and left ventricle (LV) mechanics are crucial and play an important role in the pathophysiology of aortic stenosis (AS). The pressure-volume (PV) analysis is a powerful tool to study VAC and LV mechanics. We proposed a novel minimally-invasive method for PV analysis in patients with severe AS receiving transcatheter aortic valve implantation (TAVI). Patients with severe AS were prospectively enrolled in a single center. LV pressure and cardiac output were recorded before and after TAVI. We constructed the PV loop for analysis by analyzing LV pressure and the assumed flow. 26 patients were included for final analysis. The effective arterial elastance (Ea) decreased after TAVI (3.7 ± 1.3 vs. 2.9 ± 1.1 mmHg/mL, p < 0.0001). The LV end-systolic elastance (Ees) did not change immediately after TAVI (2.4 ± 1.3 vs. 2.6 ± 1.1 mmHg/mL, p = 0.3670). The Ea/Ees improved after TAVI (1.8 ± 0.8 vs. 1.2 ± 0.4, p < 0.0001), demonstrating an immediate improvement of VAC. The stroke work (SW) did not change (7669.6 ± 1913.8 vs. 7626.2 ± 2546.9, p = 0.9330), but the pressure-volume area (PVA) decreased (14469.0 ± 4974.1 vs. 12177.4 ± 4499.9, p = 0.0374) after TAVI. The SW/PVA increased after TAVI (0.55 ± 0.12 vs. 0.63 ± 0.08, p < 0.0001) representing an improvement of LV efficiency. We proposed a novel minimally invasive method for PV analysis in patients with severe AS receiving TAVI. The VAC and LV efficiency improved immediately after TAVI. |
URI: | https://pubmed.ncbi.nlm.nih.gov/37688417/ https://scholars.lib.ntu.edu.tw/handle/123456789/636143 |
ISSN: | 2051-817X | DOI: | 10.14814/phy2.15799 |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。