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Left ventricular function during balloon dilatation of the aortic valve in elderly patients: a blind study of

H Egeblad1, A Wennevold

  • 1Medical Department B, Rigshospitalet, Copenhagen, Denmark.

British Heart Journal
|January 1, 1990
PubMed

Insights

Aortic valve balloon dilatation temporarily reduced left ventricular function, similar to brief coronary obstruction. This suggests myocardial ischemia-reperfusion effects, not just load changes, influence the heart

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Physiology

Background:

  • Aortic valve stenosis often requires intervention.
  • Balloon valvuloplasty is a treatment option.
  • Understanding the acute cardiac effects is crucial.

Purpose of the Study:

  • To investigate left ventricular response during aortic valve balloon dilatation.
  • To differentiate between load-dependent and ischemic effects on the myocardium.

Main Methods:

  • Subcostal echocardiography in ten elderly patients.
  • Continuous recording during aortic valve balloon dilatation.
  • M-mode analysis of fractional shortening and wall motion.

Main Results:

  • Left ventricular function and fractional shortening significantly decreased during balloon inflation.
  • Global left ventricular hyperkinesia and transient overshoot in function observed post-deflation.
  • Myocardial response mimicked regional effects of coronary obstruction, suggesting ischemia-reperfusion.

Conclusions:

  • Left ventricular response to aortic valve dilatation involves both altered load and myocardial ischemia-reperfusion.
  • Potential for myocardial injury appears clinically insignificant.
  • Interventricular septum thickening reduction may relate to repeated ischemia-reperfusion episodes.

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