AI Article Synopsis
- Patients with aortic stenosis receiving 19-mm valves often experience significant regression in left ventricular mass (LVM) after surgery, despite being at high risk for prosthesis-patient mismatch.
- A study of 44 patients revealed an average LVM regression of -19.3% and identified key predictors including preoperative LVM, hypertension, and the increase in aortic area post-surgery.
- Findings indicate that factors like existing hypertension and the amount of aortic area expansion are important for LVM regression one year after receiving a 19-mm valve.
Article Abstract
Objectives: Although patients with aortic stenosis, who receive 19-mm valves, are at high risk for prosthesis-patient mismatch, most of them show a significant left ventricular mass (LVM) regression postoperatively. The aim of this study was to identify factors predicting postoperative relative LVM regression in this subgroup of patients.
Methods: A population of 44 patients operated on for pure aortic stenosis and receiving a 19-mm valve was studied by echocardiography at 1.4 +/- 0.5 years postoperatively.
Results: The mean relative LVM regression was -19.3 +/- 18.9%, the mean gradient drop was -31.6 +/- 13.3 mmHg, and the mean Delta increase in aortic area index (postoperative aortic area index minus preoperative aortic area index) was 0.30 +/- 0.14 cm/m. Thirty-two patients had an indexed effective orifice area of less than 0.8 cm/m. At multivariate analysis (r = 0.63; r = 40%; P < 0.0001) preoperative LVM (P = 0.006), hypertension (P = 0.018) and Delta aortic area index (P = 0.049) were independent predictors of relative LVM regression.
Conclusions: Our study shows that, at least 1 year postoperatively, in patients receiving a 19-mm valve, LVM regression is influenced by several parameters, in particular preoperative LVM, hypertension and the magnitude of the increase in aortic area.
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| http://dx.doi.org/10.2459/01.JCM.0000223258.47180.9d | DOI Listing |
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