Epicardial Measurement of Myocardial Stiffness on Beating Heart and Non-beating Heart During a Programmed Surgical Aortic Valve Replacement for Aortic Stenosis
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Aortic Valve Stenosis
- Sponsor
- University Hospital, Rouen
- Enrollment
- 98
- Locations
- 2
- Primary Endpoint
- to compare myocardial stiffness by ShearWave elastography on not beating heart in two groups of patients referred for surgery
- Status
- Completed
- Last Updated
- 7 months ago
Overview
Brief Summary
Elastography is a new non-invasive medical technique for measuring the stiffness at a distance from a tissue. Recent advances in the development of elastography sequences for cardiac exploration suggest a more clinical approach to cardiac elastography. This study propose to compare myocardial stiffness of a group of coronary bypass patients without hypertrophic left ventricular remodeling or sequelae of myocardial infarction versus a group of patients who should benefit from a surgical aortic valve replacement for aortic stenosis.
The hypothesis is that the physiological adaptation to pressure overload constituted by aortic stenosis is responsible for a significant increase in myocardial stiffness compared to a reference group.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Group I (aortic stenosis):
- •1\. Patient undergoing planned surgical aortic valve replacement (SAVR) for aortic stenosis (aortic valve area \<1cm² or an aortic valve area index \<0.6 cm² / m²);
- •Group II: coronary bypass
- •Patient undergoing planned myocardial revascularization surgery (coronary bypass);
- •Groups I and II
- •Patient over 18 years of age;
- •Patient having read and understood the information letter and having signed the consent form;
- •Patient affiliated or benefiting from a health insurance scheme
Exclusion Criteria
- •Group II: coronary bypass
- •Ratio in TM mode of the wall thickness over the radius of the left ventricle (h / r \[0.45\]) confirmed by the TTE;
- •Scar of myocardial infarction defined by an ECG anomaly and / or hypo-akinesia on TTE, and / or a late enhancement in MRI;
- •Acute coronary syndrome less than 3 months old;
- •Significant aortic stenosis (Vmax\> 1.5 m / s);
- •Anomaly of segmental kinetics;
- •Presence of left ventricular hypertrophy
- •Groups I and II
- •Mitral valve disease (\> 1/4 confirmed by TTE);
- •Aortic insufficiency (\> 1/4 confirmed by TTE);
Outcomes
Primary Outcomes
to compare myocardial stiffness by ShearWave elastography on not beating heart in two groups of patients referred for surgery
Time Frame: Day 1
The main outcome measure is evaluated by ShearWave elastography with the measurement of Young modulus on non-beating heart
Secondary Outcomes
- To compare the diastolic myocardial stiffness of the beating heart with the myocardial stiffness of the non-beating heart(Day 1)
- Correlation between the diastolic myocardial stiffness of the beating heart and the non-beating heart with heart failure parameters(Day 1)
- Correlation between the diastolic myocardial stiffness of the beating heart and the non-beating heart with conventional diastolic indices(Day 1)
- Correlation between the diastolic myocardial stiffness of the beating heart and the non-beating heart with left ventricular mass indexed to the body surface(Day 1)
- Correlation between the diastolic myocardial stiffness of the beating heart and the non-beating heart and the prognosis(1 year)
- To compare epicardial and trans-thoracic diastolic myocardial stiffness(Day 1)