TY - JOUR
T1 - Long-term changes in left ventricular mass, chamber site and function after valve replacement in patients with severe aortic stenosis and depressed ejection fraction
AU - Pelà, Giovanna
AU - La Canna, Giovanni
AU - Metra, Marco
AU - Ceconi, Claudio
AU - Centurini, Piero Berra
AU - Alfieri, Ottavio
AU - Visioli, Odoardo
PY - 1997
Y1 - 1997
N2 - We studied 21 patients undergoing valve replacement for severe aortic stenosis and marked left ventricular dysfunction (mean ejection fraction 27 ± 7.9%) without significant coronary disease or other valve diseases. At 5-60 months (average 26 ± 18) after surgery, the patients underwent a clinical history, physical examination and a complete M-mode, two-dimensional and Doppler transthoracic echocardiographic study. Thirteen patients were examined with cardiopulmonary exercise testing. Two patients with a low preoperative transvalvular pressure gradient (<50 mmHg) died postoperatively. Nineteen patients were tested at follow-up. All patients showed an improvement in functional class, an increase in ejection fraction (EF), a normalization in left ventricular diameters, volumes and stress indices and a reduction in left ventricular mass which correlated with EF increase. Cardiopulmonary exercise testing showed a good exercise capacity. In conclusion, in patients affected by severe aortic stenosis and marked preoperative left ventricular dysfunction valve replacement induces a favorable remodeling of the left ventricle, as shown by a late postoperative examination. The regression of hypertrophy is a positive event which correlates with the improvement in EF.
AB - We studied 21 patients undergoing valve replacement for severe aortic stenosis and marked left ventricular dysfunction (mean ejection fraction 27 ± 7.9%) without significant coronary disease or other valve diseases. At 5-60 months (average 26 ± 18) after surgery, the patients underwent a clinical history, physical examination and a complete M-mode, two-dimensional and Doppler transthoracic echocardiographic study. Thirteen patients were examined with cardiopulmonary exercise testing. Two patients with a low preoperative transvalvular pressure gradient (<50 mmHg) died postoperatively. Nineteen patients were tested at follow-up. All patients showed an improvement in functional class, an increase in ejection fraction (EF), a normalization in left ventricular diameters, volumes and stress indices and a reduction in left ventricular mass which correlated with EF increase. Cardiopulmonary exercise testing showed a good exercise capacity. In conclusion, in patients affected by severe aortic stenosis and marked preoperative left ventricular dysfunction valve replacement induces a favorable remodeling of the left ventricle, as shown by a late postoperative examination. The regression of hypertrophy is a positive event which correlates with the improvement in EF.
KW - Aortic stenosis
KW - Aortic valve replacement
KW - Left ventricular dysfunction
KW - Morphological changes
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M3 - Article
C2 - 9197424
AN - SCOPUS:0030904464
VL - 88
SP - 315
EP - 322
JO - Cardiology
JF - Cardiology
SN - 0008-6312
IS - 4
ER -