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Left atrial volume index as a predictor for persistent left ventricular dysfunction after aortic valve surgery in patients with chronic aortic regurgitation: the role of early postoperative echocardiography

Authors
 In-Jeong Cho  ;  Hyuk-Jae Chang  ;  Geu-Ru Hong  ;  Ran Heo  ;  Ji Min Sung  ;  Sang-Eun Lee  ;  Byung-Chul Chang  ;  Chi Young Shim  ;  Jong-Won Ha  ;  Namsik Chung 
Citation
 Echocardiography, Vol.32(6) : 896-903, 2015 
Journal Title
 Echocardiography 
ISSN
 0742-2822 
Issue Date
2015
MeSH
Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Insufficiency/complications* ; Aortic Valve Insufficiency/diagnostic imaging ; Aortic Valve Insufficiency/surgery* ; Cardiac Valve Annuloplasty/adverse effects* ; Chronic Disease ; Echocardiography ; Female ; Heart Atria/diagnostic imaging* ; Humans ; Male ; Middle Aged ; Organ Size ; Postoperative Period ; Prognosis ; Reproducibility of Results ; Risk Factors ; Sensitivity and Specificity ; Severity of Illness Index ; Treatment Outcome ; Ventricular Dysfunction, Left/diagnostic imaging* ; Ventricular Dysfunction, Left/etiology*
Keywords
aortic regurgitation
Abstract
BACKGROUND: This study aimed to explore whether echocardiographic measurements during the early postoperative period can predict persistent left ventricular systolic dysfunction (LVSD) after aortic valve surgery in patients with chronic aortic regurgitation (AR). METHODS: We prospectively recruited 54 patients (59 ± 12 years) with isolated chronic severe AR who subsequently underwent aortic valve surgery. Standard transthoracic echocardiography was performed before the operation, during the early postoperative period (≤2 weeks), and then 1 year after the surgery. RESULTS: Twelve patients with preoperative LVSD demonstrated LVSD at early after the surgery. Of the 42 patients without LVSD at preoperative echocardiography, 15 patients (36%) developed early postoperative LVSD after surgical correction. All 27 patients without LVSD at early postoperative echocardiography maintained LV function at 1 year after surgery. In the other 27 patients with postoperative LVSD, 17 patients recovered from LVSD and 10 patients did not at 1 year after surgery. Multiple logistic analysis demonstrated that postoperative left atrial volume index (LAVI) was the only independent predictor for persistent LVSD at 1 year after surgery in patients with postoperative LVSD (OR 1.180, 95% CI, 1.003-1.390, P = 0.046). The optimal LAVI cutoff value (>34.9 mL/m(2) ) had a sensitivity of 80% and a specificity of 88% for the prediction of persistent LVSD. CONCLUSION: Prevalence of early postoperative LVSD was relatively high, even in the patients without LVSD at preoperative echocardiography. Postoperative LAVI could be useful to predict persistent LVSD after aortic valve surgery in patients with early postoperative LVSD.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/echo.12756/abstract
DOI
10.1111/echo.12756
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
5. Research Institutes (연구소) > Yonsei Cardiovascular Research Institute (심혈관연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Sung, Ji Min(성지민)
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Lee, Sang Eun(이상은) ORCID logo https://orcid.org/0000-0001-6645-4038
Chang, Byung Chul(장병철)
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Chung, Nam Sik(정남식)
Cho, In Jeong(조인정)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Heo, Ran(허란)
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140711
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