Related Experiment Video
Updated: Jul 9, 2026
04:48
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
Changes in Cardiac-Arterial Coupling After Cardiac Surgery for Aortic Valve Disease
Anna Giani1,2, Oscar Plunde1, Cristina Oliveira da Silva1,3
1Department of Medicine Solna, Karolinska Institutet, 17176 Stockholm, Sweden.
Reviews in Cardiovascular Medicine
|July 8, 2026
Summary
Aortic valve replacement surgery worsens cardiac-arterial coupling, impacting both ventricular-arterial coupling (VAC) and atrial-arterial coupling (AAC). These changes in vascular and cardiac function are detectable early after valve surgery.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Cardiac Surgery
Background:
- Aortic valve disease significantly impacts vascular and cardiac remodeling and function.
- Aortic valve replacement (AVR) may alter ventricular-arterial coupling (VAC), the interaction between the left ventricle and arterial system.
Purpose of the Study:
- To determine changes in VAC and atrial-arterial coupling (AAC) in patients with aortic valve disease before and after AVR.
Main Methods:
- 41 patients undergoing AVR were assessed pre- and post-surgery.
- Echocardiography measured left atrial reservoir strain (LARS) and left ventricular global longitudinal strain (GLS).
- Arterial stiffness was measured using carotid-femoral pulse wave velocity (cfPWV), brachial-ankle-PWV (baPWV), and cardio-ankle vascular index (CAVI). VAC and AAC were calculated as ratios of arterial stiffness to cardiac strain.
Main Results:
- Post-surgery, atrial and ventricular strain and arterial stiffness significantly worsened.
- Ventricular-arterial uncoupling increased substantially, indicated by higher arterial stiffness to LV strain ratios (p < 0.001).
- Atrial-arterial uncoupling also significantly increased post-surgery (p < 0.001 for CAVI/LARS and baPWV/GLS; p = 0.035 for cfPWV/LARS).
Conclusions:
- Worsened ventricular-arterial uncoupling is detectable early after cardiac surgery using novel VAC measures.
- This study demonstrates atrial-arterial uncoupling, suggesting generalized cardiac-arterial uncoupling post-valve surgery.
Keywords:
aortic valve replacementarterial stiffnessatrial functionatrial-arterial couplingventricular functionventricular-arterial couplingMore Related Videos
Related Concept Videos
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
01:15Aortic Regurgitation I: Introduction
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...
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
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...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
01:26Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...