Enhanced method for predicting left ventricular reverse remodeling after surgical repair of aortic regurgitation: application of ultrasonic tissue characterization.
To predict left ventricular (LV) reverse remodeling after surgical repair of aortic regurgitation, we examined 30 patients with aortic regurgitation accompanying LV dilatation by myocardial tissue characterization with integrated backscatter method. Before and after operation, the magnitude of cyclic variation of integrated backscatter (CVIB) was obtained from anterior septum and posterior wall, and averaged value was calculated in each patient. Before operation, LV end-diastolic dimension, fractional shortening, and LV end-diastolic pressure were not significantly different between the patients with (group GR) and without (group PR) decreased LV end-diastolic dimension after operation. Under these conditions, CVIB, which was 9.6 +/- 1.0 dB from healthy volunteers, was significantly greater in group GR, 5.7 +/- 1.4 dB, than that in group PR, 3.8 +/- 0.8 dB (P =.0003). The patients with CVIB >/= 4 before operation were expected to have reverse remodeling after operation with a sensitivity of 79%, a specificity of 82%. These data indicate that preoperative CVIB from the left ventricle provides pivotal information for predicting reverse remodeling after operation for aortic regurgitation in addition to the conventional echocardiographic parameters.
Hirooka
Keiji
K
Cardiology Division of Medicine, National Cardiovascular Center, Suita, Osaka, Japan. k-chan@onh.go.jp
Yasumura
Yoshio
Y
Tsujita
Yuko
Y
Hanatani
Akihisa
A
Nakatani
Satoshi
S
Hori
Masatsugu
M
Miyatake
Kunio
K
Yamagishi
Masakazu
M
D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging* / Q000601:surgery*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D020257:Ventricular Remodeling