Influence of prosthesis size and left ventricular mass on left ventricular diastolic reserve in patients with aortic valve prostheses.
OBJECTIVE
The study aim was to determine the influence of valve size and left ventricular (LV) mass on long-term LV diastolic reserve in patients subjected to aortic valve replacement for stenosis.


METHODS
Seventy-four patients (33 women, 41 men; mean age 64 years) after aortic valve replacement with 40 pericardial bioprostheses and 34 bileaflet mechanical prostheses were studied. All valves were of nominal size 19, 21 or 23 mm. The patients were studied by Doppler echocardiography, at rest and during peak effort, between 12 and 47 months after valve replacement.


RESULTS
All patients achieved significantly increased heart rate, blood pressure and cardiac output in response to effort. Effort also significantly modified transvalvular pressure drops and valve areas. The mean diastolic reserve was 29.3 ml, and mean stroke volume reserve 23.2 ml; in neither case were there any significant differences between valve types, or among valve sizes.


CONCLUSIONS
At about one year after surgery, the diastolic reserve of patients subjected to aortic valve replacement on account of stenosis was considerable, and independent of valve size. Despite the persistence of LV hypertrophy after valve replacement, LV diastolic function during effort was similar to that of the normal heart.
Gonzalez-Juanatey
J R
JR
Department of Cardiology, Hospital Clinico Universitario de Santiago, Faculty of Medicine, Santiago de Compostela, Spain.
Vega Fernandez
M
M
Gude
F
F
Durán Muñoz
D D
DD
Román
V
V
Iglesias Carreño
C
C
D000367:Age Factors; D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D001705:Bioprosthesis; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006339:Heart Rate / Q000502:physiology; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*