Prediction of postoperative left ventricular systolic function with Doppler-derived dP/dt in patients with chronic aortic regurgitation.
To evaluate the value of Doppler-derived dP/dt as a predictor of postoperative left ventricular (LV) systolic function in patients with chronic aortic regurgitation, we evaluated 29 patients who underwent aortic valve replacement (n = 17) or valve repair. Doppler-derived dP/dt was determined from the continuous wave Doppler signal of the aortic regurgitation jet preoperatively. Preoperative LV ejection fraction (LVEF) and Doppler-derived dP/dt were 48 +/- 11% and 701 +/- 204 mm Hg/s, respectively. LVEF decreased to 43 +/- 12% at immediate postoperative period and improved to 54 +/- 11% at late postoperative period. In multivariate analysis, only dP/dt was an independent predictor of late postoperative LVEF (r = 0.59, P =.006). A dP/dt <or=700 mm Hg/s was the best predictor of late postoperative systolic dysfunction (LVEF <50%) with a sensitivity of 94% and a specificity of 75%. Doppler-derived dP/dt may be useful to predict postoperative LV systolic function.
Kang
Hyun-Jae
HJ
Department of Internal Medicine, Seoul National University College of Medicine, Chongno-gu, Korea.
Kim
Yong-Jin
YJ
Sohn
Dae-Won
DW
Oh
Byung-Hee
BH
Lee
Myoung-Mook
MM
Park
Young-Bae
YB
Choi
Yun-Shik
YS
D000328:Adult; D001022:Aortic Valve Insufficiency / Q000503:physiopathology* / Q000601:surgery*; D019540:Area Under Curve; D002908:Chronic Disease; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*