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Related Concept Videos

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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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One problem two issues! Left ventricular systolic and diastolic dysfunction in aortic stenosis.

Maqsood M Elahi1, Anthony Chuang1, Michael J Ewing1

  • 11 Division of Cardiothoracic Surgery, Department of Surgery, Texas A & M Health Science Center at Scott & White Memorial Hospital, Temple, TX, USA ; 2 Division of Cardiothoracic Surgery, Prince of Wales & Sydney Children's Hospital, Barker Street, Randwick, Sydney, NSW, Australia ; 3 Liverpool Heart and Chest Hospital, NHS Foundation Trust, Liverpool, UK.

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Summary

Left ventricular diastolic dysfunction (LV-DD) is a significant risk after aortic valve replacement (AVR). This review examines the evidence linking LV-DD to immediate post-operative dysfunction, impacting patient outcomes.

Keywords:
Aortic valve stenosisaortic valve repaircardiopulmonary bypassdiastolic dysfunctionepicardial pacingleft ventricular dysfunctionleft ventricular hypertrophy

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Physiology
  • Echocardiography

Background:

  • Left ventricular (LV) dysfunction post-aortic valve replacement (AVR) is linked to increased morbidity and mortality, especially in patients needing inotropic support.
  • Established risk factors include LV systolic dysfunction, heart failure, and myocardial infarction (MI).
  • Left ventricular diastolic dysfunction (LV-DD) is increasingly recognized but less studied in the immediate post-AVR period.

Purpose of the Study:

  • To review the existing evidence on the association between left ventricular diastolic dysfunction (LV-DD) and immediate post-operative LV dysfunction following AVR.
  • To highlight the prognostic significance of LV-DD in the context of AVR surgery.

Main Methods:

  • Systematic literature review of studies investigating LV diastolic function and post-operative LV dysfunction after AVR.
  • Analysis of prognostic factors, including LV systolic and diastolic parameters.
  • Synthesis of current evidence on the role of LV-DD in immediate post-AVR outcomes.

Main Results:

  • While systolic LV function markers (e.g., LVEF) are well-studied, the impact of LV-DD on immediate post-AVR LV dysfunction requires further investigation.
  • Preliminary evidence suggests LV-DD may be a critical, underappreciated factor in post-operative cardiac performance.
  • The review consolidates findings on the relationship between pre-existing LV-DD and acute hemodynamic changes after AVR.

Conclusions:

  • Left ventricular diastolic dysfunction (LV-DD) is a crucial consideration for patients undergoing aortic valve replacement (AVR).
  • Further research is warranted to fully elucidate the impact of LV-DD on immediate post-operative outcomes and guide clinical management strategies.
  • Integrating LV-DD assessment into pre-operative evaluations may improve risk stratification and patient care following AVR.