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    Evaluation of the Effect of Aortic Stenosis and Severity on Left Ventricular Function by Isovolumic Myocardial Acceleration
    (2020) Yazan, Serkan; Akbay, Ertan; Somuncu, Mustafa Umut; Ertürk, Mehmet; Yıldırım, Aydın
    Aim: Tissue Doppler-derived isovolumic acceleration (IVA) is a parameter that evaluates thesystolic function of both ventricles, without being affected by pre-load and post-load. Weaimed to detect left ventricular systolic dysfunction at an early stage with IVA in patients withasymptomatic aortic stenosis (AS).Material and Methods: A total of 105 patients were included in the study, 75 of which hadisolated AS and 30 were free of any valve disease. Patients with AS were divided into threegroups (mild, moderate and severe) according to their aortic valve area (AVA) and aortic peakvelocities, as determined by means of a transthoracic echocardiography. Conventionalechocardiography, systolic and diastolic Tissue Doppler parameters [peak myocardial velocityduring isovolumic contraction (IVV), myocardial velocity during ejection phase (Sm), earlydiastolic myocardial velocity (e'), late diastolic myocardial velocity (a'), and acceleration time(AT)] were calculated in all patients. IVA was obtained by dividing the IVV flow rate by theAT time.Results: The systolic parameters IVV (p<0.001), Sm (p<0.001), IVA (p=0.002) and diastolicparameters e' wave (p<0.001), a' wave (p=0.001) were found to be significantly lower inpatients with AS compared to the control group. However, this relationship observed in IVAwas not different in AS subgroups (p=0.122). Sm and e' waves were positively correlated withAVA (p=0.001, p<0.001, respectively) and negatively correlated with aortic peak gradient(p=0.008, p<0.001, respectively), but IVA was not correlated.Conclusion: Left ventricular function is impaired in patients with AS and this is independentof the severity of AS.