Noninvasive assessment of myocardial dysfunction in patients with chronic aortic regurgitation.
Chronic aortic regurgitation may have minimal symptoms until severe myocardial dysfunction is apparent. Multiple preoperative indicators of postoperative prognosis have been sought. It appears that an elevated left ventricular end systolic dimension on echocardiography or elevated end systolic volume on radionuclide ventriculography in combination with depressed LV function and substantially increased calculated systolic wall stress may present an indicator for aortic valve replacement. Response of ejection fraction to stress may not be as reproducible, but when combined with a depressed resting ejection fraction may also be an indicator for aortic valve replacement. Even patients with severely depressed left ventricular ejection fraction may improve with surgery; however, the risks of a poor postoperative outcome is substantial increased. Appropriate management of a patient with chronic aortic regurgitation requires monitoring of multiple parameters during the patient's clinical course for optimal timing of valve replacement surgery.
Wilson
D B
DB
University of Kansas Medical Center, Department of Internal Medicine, Kansas City 66103.
Dunn
M I
MI
D001022:Aortic Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D002302:Cardiac Output; D009202:Cardiomyopathies / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans