title: Left ventricular mass regression is independent of gradient drop and effective orifice area after aortic valve replacement with a porcine bioprosthesis.
abstract: OBJECTIVE
  The question of whether left ventricular mass (LVM) regression following aortic valve replacement (AVR) is affected by the prosthesis indexed effective orifice area (IEOA) and transprosthetic gradient has not been fully elucidated. Data from a prospective, core-laboratory-reviewed echocardiography and magnetic resonance imaging (MRI) study was used to determine if the degree of LVM regression following AVR with two types of porcine bioprosthesis in patients suffering from predominant aortic valve stenosis (AS) was related to the prosthesis IEOA and transprosthetic gradient.
  
  
  METHODS
  Over a two-year period, 149 patients enrolled at eight centers received either an Epic or an Epic Supra aortic bioprosthesis (St. Jude Medical, MN, USA). Preoperative valve dysfunction was pure AS in 54 patients (36%) and mixed valve disease (primarily stenosis) in 95 patients (64%). LVM was determined preoperatively and at six months postoperatively, using MRI. The prosthesis IEOA and transprosthetic gradient were calculated at six months by means of echocardiography.
  
  
  RESULTS
  Data were available for 111 patients at both enrolment and six months postoperatively. The LVM at enrolment and at follow up was 154.96 +/- 42.50 g and 114.83 +/- 29.20 g, respectively (p < 0.0001). An analysis of data using Spearman rank correlation coefficients and linear regression methods, showed LVM regression to be independent of the mean systolic pressure gradient, peak systolic pressure and prosthesis IEOA at six months (p = 0.53, 0.43, and 0.15, respectively).
  
  
  CONCLUSIONS
  At six months after AVR with a porcine bioprosthesis to treat AS, there was a significant LVM regression that was independent of the prosthesis IEOA and the mean systolic pressure gradient and peak systolic pressure.
authors: Department of Cardiac Surgery, Hospital de Navarra, Pamplona, Spain. jr.sadaba.sagredo@navarra.es
authors: Justo Rafael
authors: JR
authors: Sádaba
authors: Marie-Christine
authors: MC
authors: Herregods
authors: Jan
authors: J
authors: Bogaert
authors: Wolfgang
authors: W
authors: Harringer
authors: Gino
authors: G
authors: Gerosa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D001794:Blood Pressure; D015150:Echocardiography, Doppler; D005060:Europe; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006439:Hemodynamics; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D017725:Ventricular Pressure