Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
RELATIVE APICAL SPARING IN PATIENTS WITH SEVERE AORTIC STENOSIS: PREVALENCE AND SIGNIFICANCE
Session:
Painel 9 -Doença Valvular 3
Speaker:
Joao Abecasis
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.3 Valvular Heart Disease – Diagnostic Methods
Session Type:
Posters
FP Number:
---
Authors:
João Abecasis; Gustavo Sá Mendes; António Miguel Ferreira; Carolina Campino Padrão; Regina Ribeiras; Maria João Andrade; Rosa Gouveia; Daniel Gomes Pinto; Sância Ramos; José Pedro Neves; Pergiorgio Masci; Victor M. Gil; Nuno Cardim
Abstract
<p><strong>Background:</strong> Relative apical sparing (RAS) of left ventricular longitudinal strain (LS) is a red flag for the diagnostic suspicion of amyloid cardiomyopathy (AC). However, it may present in patients with aortic stenosis, where the prevalence of transthyretin AC is being increasingly reported.</p> <p><strong>Aim:</strong> to describe the prevalence of RAS deformation pattern in patients with aortic stenosis and its clinical significance.</p> <p><strong>Methods: </strong>we prospectively studied 53 consecutive patients (age: 71±8years, 51-84 years, 54.7% men) with severe symptomatic aortic stenosis - mean transaortic pressure gradient (AVmean): 54.6 mmHg [IQR 46.6-63.2]; aortic valve area 0.74cm<sup>2 </sup>[IQR 0.61-0.89]), referred for surgical aortic valve replacement with no previous history of ischemic cardiomyopathy. Beyond 12 lead-ECG and transthoracic echocardiography (TTE), all patients underwent cardiac magnetic resonance (CMR), with tissue characterization (T1 mapping, delayed enhancement and extracellular volume-ECV), before surgery. RAS was defined as <em>average apical LS / average basal LS + average mid LS</em> <em>>1</em> at bidimensional LV longitudinal strain analysis by speckle tracking. Aortic valve replacement and septal myocardial biopsy were already performed in 26 patients. Aortic stenosis severity indexes, LV remodelling and tissue characterization was compared in both groups of patients, with and without RAS.</p> <p><strong>Results: </strong>RAS was present in 16 patients (30,8%). In the whole group of patients there were neither pseudoinfarct pattern or low voltage at ECG, nor infiltration suspicion from CMR study (native T1 value 1047ms [IQR 1028-1084]; ECV 22% [IQR 18-25]). Furthermore, none of the patients had the suspicion of amyloid deposition at histopathology.</p> <p>In overall patients, median CMR LV ejection fraction was 64,5% [IQR 51,3-70,8%] and 36 patients (67,9%) had non-ischemic delayed enhancement, with a median fraction of 6,0% [IQR 4,9-12,7%] of LV mass.</p> <p>Comparing both groups, RAS cohort showed a significantly higher AVmean, relative wall thickness, maximum septal thickness, peak systolic dispersion at TTE, as well as higher LV indexed mass, delayed enhancement and lower LV ejection fraction at CMR. RAS group has also higher NT pro BNP values (table 1).</p> <p><strong>Conclusions: </strong>RAS is relatively common in this group of patients despite the absence of clinical and histological signs of myocardial infiltration. This deformation pattern occurs in patients with worse indexes of left ventricular remodeling and fibrosis, being consistent with a more advanced stage of the disease.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site