Immediate effect of aortic valve replacement for aortic stenosis on left ventricular diastolic chamber stiffness.
Diastolic dysfunction is common after coronary artery bypass surgery, and we hypothesized that left ventricular (LV) hypertrophy associated with aortic stenosis may lead to worsening LV diastolic function after aortic valve replacement for aortic stenosis. Transesophageal echocardiographic LV images and simultaneous pulmonary arterial wedge pressures were used to define the LV diastolic pressure cross-sectional area relation before and immediately after aortic valve replacement for aortic stenosis in 14 patients. In all patients, LV diastolic chamber stiffness increased, as evidenced by a leftward shift in the LV diastolic pressure cross-sectional area relation. At comparable LV filling (pulmonary arterial wedge) pressures the mean LV end-diastolic cross-sectional area preoperatively was 17.9 +/- 1.7 cm2, but decreased by 32% after aortic valve replacement to 12.1 +/- 1.2 cm2 (p = 0.0001). In conclusion, after aortic valve replacement, diastolic chamber stiffness increased in all patients.
McKenney
P A
PA
Department of Medicine, Boston Medical Center and Boston University School of Medicine, Massachusetts 02118, USA.
Apstein
C S
CS
Mendes
L A
LA
Connelly
G P
GP
Aldea
G S
GS
Shemin
R J
RJ
Davidoff
R
R
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D003971:Diastole / Q000502:physiology*; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D013599:Systole / Q000502:physiology; D016896:Treatment Outcome