Related Experiment Videos
[Relation between hemodynamics and ventricular arrhythmia in patients with heart valve diseases]
T Meinertz1, W Kasper, W Bödecker
1Medizinische Universitätsklinik Freiburg.
Insights
Ventricular arrhythmias in mitral regurgitation correlate with regurgitation severity and impaired left ventricular function. In aortic valve disease, arrhythmias link to left ventricular dysfunction, not valve lesion type.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Valvular Heart Disease
Context:
- Ventricular arrhythmias (VAs) are a significant concern in patients with valvular heart disease.
- Understanding the relationship between valve hemodynamics and arrhythmia burden is crucial for risk stratification.
- Previous studies have explored these associations, but comprehensive analysis across different valve lesions is needed.
Purpose:
- To investigate the correlation between hemodynamic parameters obtained via cardiac catheterization and the incidence/severity of VAs.
- To compare these associations in patients with mitral valve disease (MVD) versus aortic valve disease (AVD).
- To identify specific hemodynamic factors predictive of VAs in MVD and AVD.
Summary:
- In 160 patients (68 MVD, 92 AVD), VAs correlated positively with mitral regurgitation severity and negatively with left ventricular ejection fraction and cardiac index.
- In AVD, VAs were unrelated to lesion type or pressure gradient but correlated negatively with left ventricular ejection fraction and positively with end-systolic volume and wall stress in aortic stenosis and regurgitation.
- Impaired left ventricular function is strongly associated with VAs in both MVD and AVD.
Impact:
- Provides insights into the hemodynamic determinants of VAs in specific valvular heart diseases.
- Highlights the critical role of left ventricular function in arrhythmia development.
- May inform risk stratification and therapeutic strategies for patients with MVD and AVD.
Abstract:
The incidence and severity of ventricular arrhythmias were compared with hemodynamic findings of cardiac catheterization, in 160 patients with mitral and aortic valve disease. All patients underwent right and left heart catheterization, as well as M-mode and 2D-echocardiography, and 24-hour ambulatory electrocardiographic monitoring. Out of 160 patients, 68 had mitral valve disease and 92 had aortic valve disease. In mitral regurgitation the degree and frequency of ventricular arrhythmias showed a positive correlation to the degree of regurgitation (rs = 0.44, rs = 0.56, respectively) and a negative correlation to left ventricular ejection fraction (rs = -0.49, rs = -0.57) and to cardiac index (rs = 0.48, rs = 0.53). In aortic valve disease the incidence and severity of ventricular arrhythmias were not related to the type of valve lesion, to the transvalvular pressure gradient nor to the degree of regurgitation. In aortic stenosis, the degree of arrhythmia showed a negative correlation to left ventricular ejection fraction (rs = 0.55) and a positive correlation to left ventricular endsystolic volume index (rs = 0.40) and to peak systolic left ventricular wall stress (rs = 0.59). In aortic regurgitation the number of ventricular arrhythmias showed a negative correlation to left ventricular ejection fraction (rs = -0.43) and a positive correlation to left ventricular endsystolic volume index (rs = 0.43) and to peak systolic left ventricular wall stress (rs = 0.37). These data demonstrate that the incidence and severity of ventricular arrhythmias, in patients with aortic valve disease and mitral regurgitation, are strongly associated with the impairment of left ventricular function.