Late cardiac deaths after isolated valve replacement for aortic stenosis. Relation to impaired left ventricular diastolic performance.
Sixty-three patients took part in a follow-up study ten to seventeen years after valve replacement for aortic stenosis. Data obtained were used to predict cardiac deaths (n = 14) occurring in the following three-year period. The degree of residual left ventricular (LV) hypertrophy correlated inversely with indices for LV systolic and diastolic performance (radionuclide cardiography). A logistic regression (LR) model had a positive predictive value for cardiac deaths of 100% (10/10) with 8% (4/53) false negatives. Evaluating LV performance indices exclusively, LR analysis showed that only peak filling rate had independent predictive value. Subnormal and normal LV ejection fractions were associated with equal three-year cardiac death rates (29%). Depressed LV function was related to residual hypertrophy. Impaired diastolic performance was the prime predictor of cardiac deaths.
Lund
O
O
Department of Thoracic and Cardiovascular Surgery, Skejby Sygehus/Aarhus University Hospital, Denmark.
Jensen
F T
FT
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology; D006331:Heart Diseases / Q000401:mortality*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies