Usefulness of Left Ventricular Shape to Predict the Early Recovery of Left Ventricular Function After Isolated Aortic Valve Replacement for Aortic Valve Stenosis

• Published in: The American journal of cardiology 2008-12, Vol.102 (11), p.1530-1534
• Main Authors: Matsumura, Yoshiki, MD, Gillinov, A. Marc, MD, Toyono, Manatomo, MD, Wada, Nozomi, MD, Yamano, Tetsuhiro, MD, Thomas, James D., MD, Shiota, Takahiro, MD
• Format: Article
• Language: English
• Subjects: Aged; Aortic Valve - diagnostic imaging; Aortic Valve - pathology; Aortic Valve - physiopathology; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - mortality; Aortic Valve Stenosis - pathology; Aortic Valve Stenosis - physiopathology; Aortic Valve Stenosis - surgery; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Electrocardiography; Endocardial and cardiac valvular diseases; Female; Heart; Heart surgery; Heart Valve Prosthesis Implantation; Heart Ventricles - diagnostic imaging; Heart Ventricles - pathology; Heart Ventricles - physiopathology; Humans; Male; Medical sciences; Multivariate Analysis; Prospective Studies; ROC Curve; Sensitivity and Specificity; Stroke Volume; Time Factors; Ultrasonography; Ventricular Function, Left
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2008.07.044

Improvement in left ventricular (LV) systolic function after aortic valve replacement (AVR) has been observed in patients with aortic valve stenosis (AS). However, the factors that predict such recovery remain unclear. We sought to identify the predictive value of the LV spherical shape for LV functional recovery after “isolated” AVR in patients with severe AS and LV dysfunction. We examined 90 patients with severe AS and LV systolic dysfunction by echocardiography before and after AVR. Patients with known coronary artery disease, significant aortic or mitral regurgitation, and other cardiac surgery were excluded. LV end-diastolic and end-systolic volumes indexes and ejection fraction (EF) were measured by the Simpson method. LV mass index was calculated by the area-length method. LV end-diastolic and end-systolic sphericity were calculated as the ratio of the minor axis to the major axis of the left ventricle in apical 4-chamber view. The postoperative EF was significantly associated with preoperative EF, end-diastolic and end-systolic volumes indexes, LV mass index, and end-diastolic and end-systolic sphericity (all p