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Time course of left ventricular remodeling after stentless aortic valve replacement

Background Stentless aortic valves are associated with a significant decrease in left ventricular hypertrophy. This study examined the time course and factors affecting left ventricular mass regression (LVMR) after aortic valve replacement (AVR) with Cryolife O’Brien (CLOB) (Cryolife International,...

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Published in:The American heart journal 2001-09, Vol.142 (3), p.556-562
Main Authors: Gelsomino, Sandro, Frassani, Romeo, Morocutti, Giorgio, Nucifora, Rosario, Col, Paolo Da, Minen, Giorgio, Morelli, Angelo, Livi, Ugolino
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cited_by cdi_FETCH-LOGICAL-c373t-1ac57a5368dc0bdf4f78c6e59ebab50a6c34a761d6a5098c868046a70aeca7d13
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container_title The American heart journal
container_volume 142
creator Gelsomino, Sandro
Frassani, Romeo
Morocutti, Giorgio
Nucifora, Rosario
Col, Paolo Da
Minen, Giorgio
Morelli, Angelo
Livi, Ugolino
description Background Stentless aortic valves are associated with a significant decrease in left ventricular hypertrophy. This study examined the time course and factors affecting left ventricular mass regression (LVMR) after aortic valve replacement (AVR) with Cryolife O’Brien (CLOB) (Cryolife International, Atlanta, Ga) stentless valves. Methods Between 1993 and 2000, 130 consecutive patients underwent AVR with CLOB. Mean age was 71.3 ± 6.3 years. Sixty-four (49.2%) were male. Mean body surface area (BSA) was 1.7 ± 0.2 m2. Mean valve size implanted was 23.6 ± 2.0 mm. All patients were monitored with serial echocardiograms; the first study was performed preoperatively, and subsequent controls were at 6 months, 1, 2, 3, 4, 5, 6, and 7 years, respectively. Left ventricular mass was calculated by the Devereux formula and indexed by BSA. Results Analysis of variance showed a significant reduction in the left ventricular mass index (LVMI) over time (P 1.75 m2, male sex, arterial blood pressure ≥150 mm Hg, left ventricular ejection fraction ≤35%, New York Heart Association functional class ≥III, non–sinus rhythm, and prevalent aortic incompetence to be factors influencing LVMR. LVMR was not related to postoperative effective orifice area ≤0.85 cm/m2 and prosthetic size. Conclusions AVR with a CLOB valve is followed by a significant LVMR that occurs soon after surgery. It is influenced by several patient-related factors: most of them can be predicted preoperatively. (Am Heart J 2001;142:556-62.)
doi_str_mv 10.1067/mhj.2001.117777
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This study examined the time course and factors affecting left ventricular mass regression (LVMR) after aortic valve replacement (AVR) with Cryolife O’Brien (CLOB) (Cryolife International, Atlanta, Ga) stentless valves. Methods Between 1993 and 2000, 130 consecutive patients underwent AVR with CLOB. Mean age was 71.3 ± 6.3 years. Sixty-four (49.2%) were male. Mean body surface area (BSA) was 1.7 ± 0.2 m2. Mean valve size implanted was 23.6 ± 2.0 mm. All patients were monitored with serial echocardiograms; the first study was performed preoperatively, and subsequent controls were at 6 months, 1, 2, 3, 4, 5, 6, and 7 years, respectively. Left ventricular mass was calculated by the Devereux formula and indexed by BSA. Results Analysis of variance showed a significant reduction in the left ventricular mass index (LVMI) over time (P &lt;.001). Most LVMRs occurred within the first 6 months, and after 1 year LVMI had decreased by 37.5% with further, but not statistically significant, reductions at later examinations. We found that baseline BSA &gt;1.75 m2, male sex, arterial blood pressure ≥150 mm Hg, left ventricular ejection fraction ≤35%, New York Heart Association functional class ≥III, non–sinus rhythm, and prevalent aortic incompetence to be factors influencing LVMR. LVMR was not related to postoperative effective orifice area ≤0.85 cm/m2 and prosthetic size. Conclusions AVR with a CLOB valve is followed by a significant LVMR that occurs soon after surgery. It is influenced by several patient-related factors: most of them can be predicted preoperatively. 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This study examined the time course and factors affecting left ventricular mass regression (LVMR) after aortic valve replacement (AVR) with Cryolife O’Brien (CLOB) (Cryolife International, Atlanta, Ga) stentless valves. Methods Between 1993 and 2000, 130 consecutive patients underwent AVR with CLOB. Mean age was 71.3 ± 6.3 years. Sixty-four (49.2%) were male. Mean body surface area (BSA) was 1.7 ± 0.2 m2. Mean valve size implanted was 23.6 ± 2.0 mm. All patients were monitored with serial echocardiograms; the first study was performed preoperatively, and subsequent controls were at 6 months, 1, 2, 3, 4, 5, 6, and 7 years, respectively. Left ventricular mass was calculated by the Devereux formula and indexed by BSA. Results Analysis of variance showed a significant reduction in the left ventricular mass index (LVMI) over time (P &lt;.001). Most LVMRs occurred within the first 6 months, and after 1 year LVMI had decreased by 37.5% with further, but not statistically significant, reductions at later examinations. We found that baseline BSA &gt;1.75 m2, male sex, arterial blood pressure ≥150 mm Hg, left ventricular ejection fraction ≤35%, New York Heart Association functional class ≥III, non–sinus rhythm, and prevalent aortic incompetence to be factors influencing LVMR. LVMR was not related to postoperative effective orifice area ≤0.85 cm/m2 and prosthetic size. Conclusions AVR with a CLOB valve is followed by a significant LVMR that occurs soon after surgery. It is influenced by several patient-related factors: most of them can be predicted preoperatively. (Am Heart J 2001;142:556-62.)</description><subject>Aged</subject><subject>Aortic Valve - pathology</subject><subject>Aortic Valve - surgery</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure</subject><subject>Electrocardiography</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Valve Prosthesis</subject><subject>Heart Valve Prosthesis Implantation</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Transplantations, organ and tissue grafts. 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This study examined the time course and factors affecting left ventricular mass regression (LVMR) after aortic valve replacement (AVR) with Cryolife O’Brien (CLOB) (Cryolife International, Atlanta, Ga) stentless valves. Methods Between 1993 and 2000, 130 consecutive patients underwent AVR with CLOB. Mean age was 71.3 ± 6.3 years. Sixty-four (49.2%) were male. Mean body surface area (BSA) was 1.7 ± 0.2 m2. Mean valve size implanted was 23.6 ± 2.0 mm. All patients were monitored with serial echocardiograms; the first study was performed preoperatively, and subsequent controls were at 6 months, 1, 2, 3, 4, 5, 6, and 7 years, respectively. Left ventricular mass was calculated by the Devereux formula and indexed by BSA. Results Analysis of variance showed a significant reduction in the left ventricular mass index (LVMI) over time (P &lt;.001). Most LVMRs occurred within the first 6 months, and after 1 year LVMI had decreased by 37.5% with further, but not statistically significant, reductions at later examinations. We found that baseline BSA &gt;1.75 m2, male sex, arterial blood pressure ≥150 mm Hg, left ventricular ejection fraction ≤35%, New York Heart Association functional class ≥III, non–sinus rhythm, and prevalent aortic incompetence to be factors influencing LVMR. LVMR was not related to postoperative effective orifice area ≤0.85 cm/m2 and prosthetic size. Conclusions AVR with a CLOB valve is followed by a significant LVMR that occurs soon after surgery. It is influenced by several patient-related factors: most of them can be predicted preoperatively. (Am Heart J 2001;142:556-62.)</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11526373</pmid><doi>10.1067/mhj.2001.117777</doi><tpages>7</tpages></addata></record>
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subjects Aged
Aortic Valve - pathology
Aortic Valve - surgery
Biological and medical sciences
Blood Pressure
Electrocardiography
Equipment Design
Female
Follow-Up Studies
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Humans
Male
Medical sciences
Middle Aged
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Treatment Outcome
Ventricular Dysfunction, Left
Ventricular Function, Left
Ventricular Remodeling - physiology
title Time course of left ventricular remodeling after stentless aortic valve replacement
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