Assessment of relationship between the pattern of hypertrophy and the function of left ventricle in patients with chronic aortic regurgitation.
Pre- and postoperative echocardiograms of 64 patients with chronic aortic regurgitation who had undergone isolated aortic valvular replacement (AVR) were studied. These patients were divided into 3 groups as follows: (1) Group A patients who had preoperative end-diastolic radius to wall thickness ratio (R/Thd) less than or equal to 3. (2) Group B1 patients who had preoperative R/Thd greater than 3 and end-systolic radius to wall thickness ratio (R/Ths) less than 2. (3) Group B2 patients who had preoperative R/Thd greater than 3 and R/Ths greater than or equal to 2. Using this classification we assessed the relation between the pattern of hypertrophy and left ventricular (LV) function and the reversibility of LV dysfunction following AVR. Preoperatively, ejection fraction (EF) during handgrip exercise was unchanged in Group A (% delta EF: -2.8 +/- 7.1%) and significantly decreased in Groups B1 (-17.0 +/- 5.8%) and B2 (-20.2 +/- 4.6%). In the late postoperative period, however, it was, -1.2 +/- 3.3%, -2.0 +/- 4.6%, and -17.7 +/- 8.6% in Groups A, B1, B2, respectively. Preoperatively the slope of end-systolic wall stress/volume (ESWS-ESV relation was 1.96 +/- 0.43 in Group A (p less than 0.01 vs Group B2, NS vs Group B1), 1.54 +/- 0.38 in Group B1 (NS vs Group B2) and 1.17 +/- 0.47 in Group B2. It was stressed that a good relationship existed between the pattern of hypertrophy and function as well as the reversibility of LV dysfunction following AVR.
Kasegawa
H
H
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Kawazoe
K
K
Fujita
T
T
Nakajima
N
N
Masuda
Y
Y
Park
Y D
YD
D000293:Adolescent; D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D002306:Cardiac Volume; D006332:Cardiomegaly / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D002908:Chronic Disease; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009206:Myocardium / Q000473:pathology; D013318:Stroke Volume