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Preoperative indexed left ventricular dimensions to predict early recovery of left ventricular function after aortic valve replacement for chronic aortic regurgitation

 Sang-Ho Cho  ;  Chun-Sung Byun  ;  Kwan-Wook Kim  ;  Byung-Chul Chang  ;  Kyung-Jong Yoo  ;  Sak Lee 
 CIRCULATION JOURNAL, Vol.74(11) : 2340-2345, 2010 
Journal Title
Issue Date
Adult ; Aortic Valve Insufficiency/complications ; Aortic Valve Insufficiency/diagnostic imaging ; Aortic Valve Insufficiency/mortality ; Aortic Valve Insufficiency/physiopathology ; Aortic Valve Insufficiency/surgery* ; Chronic Disease ; Echocardiography, Doppler* ; Female ; Heart Valve Prosthesis Implantation*/adverse effects ; Heart Valve Prosthesis Implantation*/mortality ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Odds Ratio ; Predictive Value of Tests ; Preoperative Care ; Proportional Hazards Models ; Recovery of Function ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sensitivity and Specificity ; Severity of Illness Index ; Stroke Volume ; Systole ; Time Factors ; Treatment Outcome ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Dysfunction, Left/etiology* ; Ventricular Dysfunction, Left/mortality ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Function, Left*
Aortic valve replacement ; Chronic aortic regurgitation ; Ventricular function
BACKGROUND: Aortic valve replacement (AVR) improves left ventricular (LV) systolic function in patients with chronic aortic regurgitation (AR). The objective of this study is to determine predictors for normalization of impaired LV systolic function after valve replacement for chronic AR.

METHODS AND RESULTS: Between 1997 and 2007, 171 patients underwent AVR for severe chronic AR. Of these patients, 79 patients with LV systolic dysfunction or severe LV dilatation preoperatively, who were evaluated by echocardiography at predischarge and early follow up (mean, 6 months) were examined. The mean preoperative ejection fraction was 49%. The mean LV end-systolic and end-diastolic dimensions were 52.32 ± 8.35 mm and 69.59 ± 7.80 mm, respectively. In the early follow up, 62 of 79 patients exhibited restored normal LV function. LV end-systolic dimension and LV end-diastolic dimension were significantly decreased early after AVR (52.32 ± 8.35 mm vs 37.82 ± 6.88 mm, and 69.59 ± 7.80 mm vs 51.55 ± 6.40 mm, respectively). Operative mortality was 3.7%. Multivariate stepwise regression analysis revealed that preoperative indexed LV end-systolic and end-diastolic dimensions were independent predictors of restored LV systolic function. The sensitivity and specificity in predicting normalization of LV function were 88% and 92% for indexed LVESD <35.32 mm/m(2) and 71% and 86% for indexed LVEDD <44.42 mm/m(2).

CONCLUSIONS: In patients who received a valve replacement for chronic AR, smaller indexed LV systolic and diastolic dimensions were associated with early restoration of LV systolic function.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Byun, Chun Sung(변천성)
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Chang, Byung Chul(장병철)
Cho, Sang Ho(조상호)
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