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AuthorTibi, Raiddc.contributor.author
Date of accession2019-07-12T13:37:58Zdc.date.accessioned
Available in OPARU since2019-07-12T13:37:58Zdc.date.available
Year of creation2018dc.date.created
Date of first publication2019-07-12dc.date.issued
AbstractAims: To assess left-ventricular strain parameters before and after transcatheter aortic valve replacement (TAVR) by feature tracking cardiac magnetic resonance imaging (FT CMR) and to correlate the findings to hemodynamic state and left-ventricular remodeling. Methods and results: Patients with symptomatic AS underwent FT CMR before and after TAVR. Patients were carefully evaluated by a comprehensive work-up including CMR, echocardiography and left and right heart catheterization. Thirty patients formed the study population. High-flow/high-gradient (HF/HG) aortic stenosis was diagnosed in 11 patients (36.7%), 6 patients (20.0%) exhibited low-flow/low-gradient AS (LF/LG) and 13 patients (43.3%) were classified to have so-called paradoxical low-flow/low-gradient (PLF/LG) AS. The HF/HG patients had a significantly reduced longitudinal strain which recovered after TAVR (−12.67 ± 4.60 to −15.46 ± 5.61%, p = 0.048). In the LF/LG group, an even more pronounced reduction of longitudinal strain and also an impairment of longitudinal velocity could be observed. Both parameters improved after therapy (strain: −5.06 ± 4.25 to −8.02 ± 3.28%, p = 0.045; velocity: 25.33 ± 9.63 to 37.13 ± 11.64 mm/s, p = 0.042). Patients with PLF/LG showed preserved longitudinal strain but a reduction of longitudinal velocity similar to the LF/LG group. These patients did not show a significant improvement of strain parameters after TAVR. Longitudinal velocity exhibited the highest predictive power for the identification of a low-flow state (sensitivity 75%, specificity 80%). Conclusion: Improvement of longitudinal strain parameters after TAVR is dependent on the initial hemodynamically defined AS subgroup.dc.description.abstract
Languagededc.language.iso
PublisherUniversität Ulmdc.publisher
LicenseStandarddc.rights
Link to license texthttps://oparu.uni-ulm.de/xmlui/license_v3dc.rights.uri
KeywordCardiac magnetic resonance imagingdc.subject
KeywordStrain imagingdc.subject
Keywordcardiac mechanicsdc.subject
Keywordsevere aortic stenosisdc.subject
Dewey Decimal GroupDDC 610 / Medicine & healthdc.subject.ddc
MeSHMagnetic resonance imagingdc.subject.mesh
MeSHAortic valve stenosisdc.subject.mesh
MeSHTranscatheter aortic valve replacementdc.subject.mesh
MeSHHemodynamicsdc.subject.mesh
TitleDie kardiale Mechanik erfasst mittels Magnetresonanztomographie korreliert mit der Hämodynamik von Patienten mit hochgradiger Aortenklappenstenose und dem positiven Remodeling nach transfemoralem Aortenklappenersatzdc.title
Resource typeDissertationdc.type
Date of acceptance2019-06-28dcterms.dateAccepted
RefereeWöhrle, Jochendc.contributor.referee
RefereeKratzer, Wolfgangdc.contributor.referee
DOIhttp://dx.doi.org/10.18725/OPARU-16244dc.identifier.doi
PPN1669117464dc.identifier.ppn
URNhttp://nbn-resolving.de/urn:nbn:de:bsz:289-oparu-16301-9dc.identifier.urn
GNDKernspintomografiedc.subject.gnd
GNDAortenklappenersatzdc.subject.gnd
GNDAortenstenosedc.subject.gnd
GNDHämodynamikdc.subject.gnd
FacultyMedizinische Fakultätuulm.affiliationGeneral
InstitutionUKU. Klinik für Innere Medizin IIuulm.affiliationSpecific
InstitutionUKU. Klinik für Innere Medizin Iuulm.affiliationSpecific
Grantor of degreeMedizinische Fakultätuulm.thesisGrantor
DCMI TypeTextuulm.typeDCMI
CategoryPublikationenuulm.category
Bibliographyuulmuulm.bibliographie


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