Left Ventricular Reverse Remodeling after Surgical Aortic Valve Replacement for Aortic Regurgitation-An Explorative Study

被引:0
作者
Arnold, Zsuzsanna [1 ,2 ]
Elnekheli, Alexander [3 ]
Geisler, Daniela [1 ,2 ]
Aschacher, Thomas [1 ,2 ]
Lenz, Verena [1 ,2 ]
Winkler, Bernhard [1 ,2 ,3 ]
Moidl, Reinhard [1 ,2 ]
Grabenwoeger, Martin [1 ,2 ,3 ]
机构
[1] Clin Floridsdorf, Dept Cardiovasc Surg, A-1210 Vienna, Austria
[2] Karl Landsteiner Soc, Inst Cardiovasc Res, A-1210 Vienna, Austria
[3] Sigmund Freud Univ, Med Fac, A-1020 Vienna, Austria
关键词
reverse remodeling; aortic regurgitation; biological valve; mechanical valve; TRANSCATHETER; HEMODYNAMICS; DEFINITIONS; HYPERTROPHY; REGRESSION; STENTLESS; SURGERY; IMPACT;
D O I
10.3390/diseases12080191
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background: The timing of treatment for chronic aortic valve regurgitation (AR), especially in asymptomatic patients, is gaining attention since less invasive strategies have become available. The aim of the present study was to evaluate left ventricular reverse remodeling after aortic valve replacement (AVR) for severe AR. Methods: Patients (n = 25) who underwent surgical AVR for severe AR with left ventricular ejection fraction (LVEF) less than 55% were included in this study. Preprocedural and follow-up clinical and echocardiographic measurements of LVEF and left ventricular (LV) diameters were retrospectively analyzed. Results: Mean LVEF increased significantly following surgical AVR (p < 0.0001). LV diameters showed a clear regression (p = 0.0088). Younger patients and those receiving a mechanical valve tended to have less improved LVEF on follow-up than patients over 60 years or the ones who were implanted with a biological prosthesis (p = 0.0239 and p = 0.069, respectively). Gender had no effect on the degree of LVEF improvement (p = 0.4908). Conclusions: We demonstrated significant LV reverse remodeling following AVR for AR. However, more data are needed on LV functional and geometrical improvement comparing the different types of valve prostheses to provide an optimal treatment strategy.
引用
收藏
页数:10
相关论文
共 32 条
[1]   Long-Term Outcomes After Aortic Valve Surgery in Patients With Asymptomatic Chronic Aortic Regurgitation and Preserved LVEF Impact of Baseline and Follow-Up Global Longitudinal Strain [J].
Alashi, Alaa ;
Khullar, Tamanna ;
Mentias, Amgad ;
Gillinov, A. Marc ;
Roselli, Eric E. ;
Svensson, Lars G. ;
Popovic, Zoran B. ;
Griffin, Brian P. ;
Desai, Milind Y. .
JACC-CARDIOVASCULAR IMAGING, 2020, 13 (01) :12-21
[2]  
Arias Eduardo A, 2019, Interv Cardiol, V14, P26, DOI 10.15420/icr.2018.37.1
[3]  
Basarir S, 2000, J HEART VALVE DIS, V9, P45
[4]   Validity and reliability of the NYHA classes for measuring research outcomes in patients with cardiac disease [J].
Bennett, JA ;
Riegel, B ;
Bittner, V ;
Nichols, J .
HEART & LUNG, 2002, 31 (04) :262-270
[5]   SURVIVAL AND FUNCTIONAL RESULTS AFTER VALVE-REPLACEMENT FOR AORTIC REGURGITATION FROM 1976 TO 1983 - IMPACT OF PREOPERATIVE LEFT-VENTRICULAR FUNCTION [J].
BONOW, RO ;
PICONE, AL ;
MCINTOSH, CL ;
JONES, M ;
ROSING, DR ;
MARON, BJ ;
LAKATOS, E ;
CLARK, RE ;
EPSTEIN, SE .
CIRCULATION, 1985, 72 (06) :1244-1256
[6]   Myocardial fibrosis in chronic aortic regurgitation - Molecular and cellular responses to volume overload [J].
Borer, JS ;
Truter, S ;
Herrold, EM ;
Falcone, DJ ;
Pena, M ;
Carter, JN ;
Dumlao, TF ;
Lee, JA ;
Supino, PG .
CIRCULATION, 2002, 105 (15) :1837-1842
[7]   Standardized definitions of structural deterioration and valve failure in assessing long-termdurability of transcatheter and surgical aortic bioprosthetic valves: a consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) endorsed by the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) [J].
Capodanno, Davide ;
Petronio, Anna S. ;
Prendergast, Bernard ;
Eltchaninoff, Helene ;
Vahanian, Alec ;
Modine, Thomas ;
Lancellotti, Patrizio ;
Sondergaard, Lars ;
Ludman, Peter F. ;
Tamburino, Corrado ;
Piazza, Nicolo ;
Hancock, Jane ;
Mehilli, Julinda ;
Byrne, Robert A. ;
Baumbach, Andreas ;
Kappetein, Arie Pieter ;
Windecker, Stephan ;
Bax, Jeroen ;
Haude, Michael .
EUROPEAN HEART JOURNAL, 2017, 38 (45) :3382-+
[8]   Aortic stenosis [J].
Carabello, Blase A. ;
Paulus, Walter J. .
LANCET, 2009, 373 (9667) :956-966
[9]   FLUID MECHANICS OF ARTIFICIAL HEART VALVES [J].
Dasi, Lakshmi P. ;
Simon, Helene A. ;
Sucosky, Philippe ;
Yoganathan, Ajit P. .
CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, 2009, 36 (02) :225-237
[10]   Do Guideline-Based Indications Result in an Outcome Penalty for Patients With Severe Aortic Regurgitation? [J].
de Meester, Christophe ;
Gerber, Bernhard L. ;
Vancraeynest, David ;
Pouleur, Anne-Catherine ;
Noirhomme, Philippe ;
Pasquet, Agnes ;
de Kerchove, Laurent ;
El Khoury, Gebrine ;
Vanoverschelde, Jean-Louis .
JACC-CARDIOVASCULAR IMAGING, 2019, 12 (11) :2126-2138