title: Exercise echocardiography predicts postoperative left ventricular remodeling in aortic regurgitation.
abstract: OBJECTIVE
  We aimed to investigate if preoperative left ventricular (LV) function assessed by exercise echocardiography could predict late postoperative LV function in aortic regurgitation (AR) patients and to evaluate how LV long-axis function is affected late after aortic valve surgery.
  
  
  METHODS
  A total of 21 male chronic AR patients, aged 49 ( 12 ) years, accepted for surgery were examined preoperatively, 6 months-, and 4 years postoperatively, at rest and during exercise. Besides conventional echocardiographic parameters, the atrioventricular plane displacement (AVPD) by M-mode and peak systolic velocity (s') in the basal LV by color tissue Doppler were measured.
  
  
  RESULTS
  Preoperatively EF rest and EF exercise, were 55( 7 )% and 54( 9 )%, respectively, and ∆EF 0( 8 )%. LV dimensions and volumes indexed to BSA had decreased at the 6-month follow-up and were stable at late follow-up. s'rest, s'exercise, AVPD rest, and AVPD exercise were unchanged at both the postoperative examinations (all P ≥ 0.05). Preoperative EF exercise and AVPD exercise showed inverse correlation to late postoperative indexed LV enddiastolic volume (r = -0.68, p < 0.004 and r = -0.86, P < 0.001) and indexed LV endsystolic volume (r = -0.68, P = 0.004 and r = -0.81, P < 0.001), while there was no correlation to preoperative EF rest and AVPD rest (all r < 0.2).
  
  
  CONCLUSIONS
  Preoperative exercise echocardiography can detect AR patients with suboptimal LV remodeling late postoperatively.
authors.affiliation: Division of Clinical Physiology, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University , Linköping , Sweden.
authors.forename: Lena M
authors.initials: LM
authors.lastname: Forsberg
authors.forename: Eva
authors.initials: E
authors.lastname: Nylander
authors.forename: Éva
authors.initials: É
authors.lastname: Tamás
mesh_terms: D001022:Aortic Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002908:Chronic Disease; D018618:Echocardiography, Doppler, Color; D025401:Echocardiography, Stress; D005080:Exercise Test; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling