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P8.5 Evaluation of Valvuloarterial Impedance in Aortic Valve Stenosis by Using Cardiac Magnetic Resonance and Carotid Artery Tonometry

Abstract

In aortic valve stenosis (AVS), valvuloarterial impedance (Zva), as left ventricle (LV) afterload estimation, has been proposed in echocardiography (TTE) to predict adverse outcome better than conventional parameters such as aortic valve area (AVA). However its calculation method differs from standard temporal arterial characteristic impedance (Zc) assessment. The aim of our study was to apply the Zc concept of measurements to estimate Zva by using phase contrast magnetic resonance (PC-MR) and carotid tonometry.

Methods

40 patients (76±13 years, 21 males) underwent MR with carotid tonometry and TTE.

  • Zva-TTE was assessed with brachial systolic arterial pressure, TTE transvalvular mean gradient and stroke volume index to body surface area.

  • Zva-MR was assessed with pressure waveform from carotid tonometry, transvalvular pressure gradient and Flow waveform on LV outflow track from PC-MR. These methods were evaluated by comparing their links with diastolic dysfunction estimated by TTE E/Ea ratio.

Results

Zva values were higher in symptomatic patients using both TTE and MR. In univariate analysis, only Zva-MR was correlated with E/Ea (r=0,5, p=0,001).

In multivariate analysis of determinants of E/Ea, a significant model including age, Mean blood pressure, LV ejection fraction, LV mass and AVA was obtained (R2=0,41; p<0,01).When Zva-MR was included, the overall significance of the model was higher (R2=0,56;p<0,01). Only Zva-MR and LV Mass remained independently correlated to E/Ea.

Conclusions

By using MR in association with carotid tonometry, the calculation of Zva is feasible and can improve LV afterload assessment in AVS. This new way to estimate Zva may be clinically useful in patients evaluation.

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This is an open access article distributed under the CC BY-NC license http://creativecommons.org/licenses/by/4.0/.

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Soulat, G., Bollache, E., Pontnau, F. et al. P8.5 Evaluation of Valvuloarterial Impedance in Aortic Valve Stenosis by Using Cardiac Magnetic Resonance and Carotid Artery Tonometry. Artery Res 8, 152 (2014). https://doi.org/10.1016/j.artres.2014.09.180

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  • DOI: https://doi.org/10.1016/j.artres.2014.09.180