title: Recovery of long-axis left ventricular function after aortic valve replacement in patients with severe aortic stenosis.
abstract: BACKGROUND
  Patients with aortic stenosis (AS) should undergo aortic valve replacement (AVR) before irreversible LV dysfunction has developed. Assessment of long-axis left ventricular (LV) function may assist in proper timing of AVR.
  
  
  OBJECTIVE
  To assess serial changes in long-axis LV function before and after AVR in patients with severe AS and preserved LV ejection fraction.
  
  
  METHODS
  The study comprised 27 consecutive patients (mean age 64.9 ± 11.7 years, 15 males) with symptomatic severe AS, scheduled for AVR. Seventeen subjects without known cardiac disease, matched for age, gender, LV ejection fraction and cardiovascular risk factors, served as a control group. Long-axis LV function assessment was done with tissue Doppler imaging at 3 weeks, 6 months, and 12 months after AVR.
  
  
  RESULTS
  Mean aortic valve area in the AS group was 0.70 ± 0.24 cm². Pre-AVR peak systolic mitral annular velocities were significantly lower compared to controls (6.7 ± 1.5 vs. 8.9 ± 2.0 cm/s, P < 0.05). Post-AVR peak systolic mitral annular velocities improved to 9.1 ± 2.9 at 3 weeks, 8.6 ± 2.7 at 6 months, and 8.1 ± 1.7 cm/s at 12 months (P < 0.05). Improvements were seen over the whole range of pre-AVR peak systolic mitral annular velocities. Patients with improved Sm after AVR (defined as ≥ 10% compared to baseline values) did not differ in baseline characteristics as compared to those who did not improve.
  
  
  CONCLUSIONS
  In patients with severe AS and preserved LV ejection fraction, abnormal systolic mitral annular velocities improve after AVR, independent of the pre-AVR value.
authors.affiliation: Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands. t.w.galema@erasmusmc.nl
authors.forename: Tjebbe W
authors.initials: TW
authors.lastname: Galema
authors.forename: Sing-Chien
authors.initials: SC
authors.lastname: Yap
authors.forename: Osama I I
authors.initials: OI
authors.lastname: Soliman
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Van Thiel
authors.forename: Folkert J Ten
authors.initials: FJ
authors.lastname: Cate
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Brandenburg
authors.forename: Ad J J C
authors.initials: AJ
authors.lastname: Bogers
authors.forename: Maarten L
authors.initials: ML
authors.lastname: Simoons
authors.forename: Marcel L
authors.initials: ML
authors.lastname: Geleijnse
mesh_terms: D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*