Recovery of long-axis left ventricular function after aortic valve replacement in patients with severe aortic stenosis.
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.
Galema
Tjebbe W
TW
Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands. t.w.galema@erasmusmc.nl
Yap
Sing-Chien
SC
Soliman
Osama I I
OI
Van Thiel
Robert J
RJ
Cate
Folkert J Ten
FJ
Brandenburg
Hans J
HJ
Bogers
Ad J J C
AJ
Simoons
Maarten L
ML
Geleijnse
Marcel L
ML
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*