Doppler echocardiographic assessment of the effect of balloon aortic valvuloplasty on left ventricular systolic function.

In order to evaluate the effects of balloon aortic valvuloplasty on left ventricular systolic function and ejection dynamics, Doppler echocardiographic studies were performed on 29 patients before and following valvuloplasty. Continuous wave aortic velocity signals were digitized and (with catheterization laboratory before and after valvuloplasty valve areas) were used to calculate: stroke volume; ejection time; ejection rate; time to 25%, 50%, and 75% ejection; accelerative (onset systole to peak velocity) ejection volume, time, and rate; and decelerative (peak velocity to end systole) ejection volume, time, and rate. Following valvuloplasty, there were no significant changes in heart rate; time to 25%, 50%, and 75% ejection; accelerative ejection time; and decelerative ejection time. There were significant increases in stroke volume, total ejection rate, accelerative ejection volume, decelerative ejection volume, accelerative ejection rate, and decelerative ejection rate, and a significant decrease in total ejection time. Balloon aortic valvuloplasty has a significant effect on the dynamics of left ventricular ejection. There is an increase in stroke volume and a decrease in ejection time, with relatively little effect on early systole, and a more pronounced effect in late systole. There are significant increases in accelerative and decelerative ejection volumes and rates, and a decrease in the time required for the last 25% of ejection. By improving the mobility of calcified leaflets, balloon aortic valvuloplasty may reduce the forces opposing forward blood movement during the decelerative phase of aortic ejection.