[Regression of myocardial hypertrophy in aortic valve disease following aortic valve replacement].
In patients with aortic valve disease successful valve replacement leads to a significant decrease in left ventricular angiographic mass, which 14-15 months postoperatively ranges between 31 and 37% of the preoperative value. Postoperative normalization of angiographic mass occurs in 2/3 of the patients with aortic stenosis and in 1/3 of the patients with aortic insufficiency. The degree of preoperative hypertrophy determines whether angiographic mass does or does not normalize after valve replacement. In patients with aortic stenosis and combined lesions, left ventricular end-diastolic wall thickness decreases postoperatively and remains unchanged in the patients with aortic insufficiency. Muscle fiber diameter decreases significantly in the first two years after valve replacement and thereafter remains unchanged. The upper limit of normal (20 mu) is not reached. Relative interstitial fibrosis increases early after surgery whereas left ventricular fibrous content remains unchanged during the first two years after valve replacement. Five years postoperatively there was a significant decrease in left ventricular fibrous content both in patients with aortic stenosis and with aortic insufficiency. Hence there appears to be no longer any validity in the earlier concept that a once established interstitial fibrosis in patients with concentric and eccentric hypertrophy is irreversible after removal of the abnormal hemodynamic burden.
Krayenbühl
H P
HP
Medizinische Poliklinik, Universitätsspital, Zürich.
Hess
O M
OM
Schneider
J
J
Turina
M
M
D001022:Aortic Valve Insufficiency / Q000150:complications* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000601:surgery; D006332:Cardiomegaly / Q000209:etiology* / Q000503:physiopathology; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D012075:Remission, Spontaneous
Regression der Myokardhypertrophie bei Aortenvitien nach Aortenklappenersatz.