title: Left atrial volume index as a predictor for persistent left ventricular dysfunction after aortic valve surgery in patients with chronic aortic regurgitation: the role of early postoperative echocardiography.
abstract: BACKGROUND
  This study aimed to explore whether echocardiographic measurements during the early postoperative period can predict persistent left ventricular systolic dysfunction (LVSD) after aortic valve surgery in patients with chronic aortic regurgitation (AR).
  
  
  METHODS
  We prospectively recruited 54 patients (59 ± 12 years) with isolated chronic severe AR who subsequently underwent aortic valve surgery. Standard transthoracic echocardiography was performed before the operation, during the early postoperative period (≤2 weeks), and then 1 year after the surgery.
  
  
  RESULTS
  Twelve patients with preoperative LVSD demonstrated LVSD at early after the surgery. Of the 42 patients without LVSD at preoperative echocardiography, 15 patients (36%) developed early postoperative LVSD after surgical correction. All 27 patients without LVSD at early postoperative echocardiography maintained LV function at 1 year after surgery. In the other 27 patients with postoperative LVSD, 17 patients recovered from LVSD and 10 patients did not at 1 year after surgery. Multiple logistic analysis demonstrated that postoperative left atrial volume index (LAVI) was the only independent predictor for persistent LVSD at 1 year after surgery in patients with postoperative LVSD (OR 1.180, 95% CI, 1.003-1.390, P = 0.046). The optimal LAVI cutoff value (>34.9 mL/m(2) ) had a sensitivity of 80% and a specificity of 88% for the prediction of persistent LVSD.
  
  
  CONCLUSIONS
  Prevalence of early postoperative LVSD was relatively high, even in the patients without LVSD at preoperative echocardiography. Postoperative LAVI could be useful to predict persistent LVSD after aortic valve surgery in patients with early postoperative LVSD.
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Korea.
authors.forename: In-Jeong
authors.initials: IJ
authors.lastname: Cho
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Korea.|Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyuk-Jae
authors.initials: HJ
authors.lastname: Chang
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Korea.
authors.forename: Geu-Ru
authors.initials: GR
authors.lastname: Hong
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Korea.
authors.forename: Ran
authors.initials: R
authors.lastname: Heo
authors.affiliation: Department of Statistics, Graduate School of Health and Welfare, CHA University, Seoul, Korea.
authors.forename: Ji Min
authors.initials: JM
authors.lastname: Sung
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Korea.
authors.forename: Sang-Eun
authors.initials: SE
authors.lastname: Lee
authors.affiliation: Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Seoul, Korea.
authors.forename: Byung-Chul
authors.initials: BC
authors.lastname: Chang
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Korea.
authors.forename: Chi Young
authors.initials: CY
authors.lastname: Shim
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Korea.
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Ha
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Korea.
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D058385:Cardiac Valve Annuloplasty / Q000009:adverse effects*; D002908:Chronic Disease; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011184:Postoperative Period; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*
keywords: aortic regurgitation