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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
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.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140711
DOI
10.1111/echo.12756
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실)
1. Journal Papers (연구논문) > 5. Research Institutes (연구소) > Yonsei Cardiovascular Research Institute (심혈관연구소)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
성지민(Sung, Ji Min) ; 심지영(Shim, Chi Young) ; 이상은(Lee, Sang Eun) ; 장병철(Chang, Byung Chul) ; 장혁재(Chang, Hyuck Jae) ; 정남식(Chung, Nam Sik) ; 조인정(Cho, In Jeong) ; 하종원(Ha, Jong Won) ; 허란(Heo, Ran) ; 홍그루(Hong, Geu Ru)
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Full Text
http://onlinelibrary.wiley.com/doi/10.1111/echo.12756/abstract
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