{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:41:19Z","timestamp":1761864079667,"version":"3.44.0"},"reference-count":27,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T00:00:00Z","timestamp":1582675200000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005416","name":"Norges Forskningsr\u00e5d","doi-asserted-by":"publisher","award":["203489"],"award-info":[{"award-number":["203489"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2020,2,6]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The physiological determinants of left ventricular (LV) mechanical dispersion (MD) are not fully explored. We aimed to investigate the impact of afterload reduction and changes in ventricular conduction on LV MD after transcatheter aortic valve implantation (TAVI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with severe aortic stenosis (AS) were examined in a prospective, repeated measures observational cohort study before and after an uncomplicated transfemoral TAVI in a single tertiary centre. LV MD was assessed by speckle tracking echocardiography. Valvulo-arterial impedance (ZVA) was used as a measure of global afterload.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 140 consecutive patients (83\u00b18 years old, 49% women, logistic EuroSCORE 16\u00b110) with severe AS (valve area 0.7\u00b10.2\u2009cm<jats:sup>2<\/jats:sup>, mean transvalvular gradient 54\u00b118\u2009mm Hg) and a relatively preserved LV ejection fraction (52%\u00b111%). After TAVI, we observed favourable changes in transvalvular gradients and ZVA in all patients. Compared with baseline, postprocedural MD was significantly lower in 108 patients with unchanged ventricular conduction (55\u00b117 ms vs 51\u00b117 ms, p=0.02) and higher in 28 patients with TAVI-induced left bundle branch block (51\u00b113 ms vs 62\u00b119 ms, p\u22640.001). During 22\u00b19 months observation, 22 patients died. Postprocedural MD was associated with mortality in a univariate Cox regression model (HR=1.24 (1.01\u20131.52), p&lt;0.04, per 10 ms increase).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Isolated afterload reduction was associated with reduction of MD, while concomitant impairment of ventricular conduction resulted in a more pronounced MD after TAVI, indicating that loading conditions and conduction should be considered when evaluating MD. A pronounced postprocedural LV MD was associated with mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2019-001199","type":"journal-article","created":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T04:15:39Z","timestamp":1582776939000},"page":"e001199","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of transcatheter aortic valve implantation on mechanical dispersion"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9801-7905","authenticated-orcid":false,"given":"Lars Gunnar","family":"Klaeboe","sequence":"first","affiliation":[{"name":"Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital Rikshospitalet, Oslo, Norway"},{"name":"K.G. Jebsen Center for Cardiac Research, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e5l Haugar","family":"Brekke","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital Rikshospitalet, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Aaberge","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital Rikshospitalet, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Haugaa","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital Rikshospitalet, Oslo, Norway"},{"name":"K.G. Jebsen Center for Cardiac Research, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thor","family":"Edvardsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital Rikshospitalet, Oslo, Norway"},{"name":"K.G. Jebsen Center for Cardiac Research, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,2,26]]},"reference":[{"key":"2025081709462778000_7.1.e001199.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.08.040"},{"key":"2025081709462778000_7.1.e001199.2","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.echo.2017.02.009","article-title":"Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the European association of cardiovascular imaging and the American Society of echocardiography","volume":"30","author":"Baumgartner","year":"2017","journal-title":"J Am Soc Echocardiogr"},{"key":"2025081709462778000_7.1.e001199.3","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1016\/j.echo.2019.01.019","article-title":"The association between longitudinal strain at rest and stress and outcome in asymptomatic patients with moderate and severe aortic stenosis","volume":"32","author":"Levy-Neuman","year":"2019","journal-title":"J Am Soc Echocardiogr"},{"key":"2025081709462778000_7.1.e001199.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.11.005"},{"key":"2025081709462778000_7.1.e001199.5","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.echo.2015.12.008","article-title":"Mechanical dispersion assessed by strain echocardiography is associated with malignant arrhythmias in Chagas cardiomyopathy","volume":"29","author":"Barros","year":"2016","journal-title":"J Am Soc Echocardiogr"},{"key":"2025081709462778000_7.1.e001199.6","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew005"},{"key":"2025081709462778000_7.1.e001199.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2012.02.004"},{"key":"2025081709462778000_7.1.e001199.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2013.03.005"},{"key":"2025081709462778000_7.1.e001199.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2014.12.023"},{"key":"2025081709462778000_7.1.e001199.10","unstructured":"Perry R , Patil S , Marx C , et al . 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