scholarly journals Adverse effects of left ventricular electrical dyssynchrony on cardiac reverse remodeling and prognosis after aortic valve surgery

2018 ◽  
Vol 72 (5) ◽  
pp. 385-392 ◽  
Author(s):  
Soo Youn Lee ◽  
Chi Young Shim ◽  
Geu-Ru Hong ◽  
In Jeong Cho ◽  
Seng Chan You ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Adverse Effects ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Reverse Remodeling ◽  
Aortic Valve Surgery

Left ventricular reverse remodeling after aortic valve surgery for acute versus chronic aortic regurgitation

2016 ◽  
Vol 33 (10) ◽  
pp. 1458-1464 ◽  
Author(s):  
Madelien V. Regeer ◽  
Michel I. M. Versteegh ◽  
Nina Ajmone Marsan ◽  
Martin J. Schalij ◽  
Robert J. M. Klautz ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Reverse Remodeling ◽  
Aortic Valve Surgery ◽  
Left Ventricular Reverse Remodeling ◽  
Chronic Aortic Regurgitation

scholarly journals Utility of dobutamine stress echocardiography in aortic valve regurgitation and reduced left ventricular function

2021 ◽  
Author(s):  
Chihiro Saito ◽  
Kotaro Arai ◽  
Kyomi Ashihara ◽  
Hiroshi Niinami ◽  
Nobuhisa Hagiwara
Keyword(s):  
Aortic Valve ◽  
Stress Echocardiography ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Left Ventricular Ejection ◽  
Reverse Remodeling ◽  
Aortic Valve Surgery ◽  
Ventricular Ejection Fraction

Objective: Predictors for post-operative reverse remodeling in patients with severe aortic regurgitation (AR) and reduced left ventricular ejection fraction (LVEF) are unknown. We performed low-dose dobutamine stress echocardiography (DSE) in patients with severe AR and reduced LVEF to evaluate the relationship between contractile reserve (CR) and reverse remodeling after surgery. Methods: In 31 patients with chronic severe AR and reduced LVEF (LVEF < 50%), we performed pre-operative DSE, assessed CR and examined whether changes in preoperative DSE were associated with improvement of post-operative LVEF after aortic valve surgery. Results: The pre-operative echocardiographic findings were as follows: left ventricular (LV) end-diastolic dimension: 67 ± 10 mm, LV end-systolic dimension: 52 ± 13 mm and LVEF: 42% ± 8%. All patients underwent aortic valve surgery. Patients with pre-operative LVEF of >45% exhibited a significant increase in LVEF; however, patients with pre-operative LVEF of <45% showed no significant change. When we examined the results of DSE performed in patients with pre-operative LVEF of <45%, ΔLVEF of ≥6% (with CR) during DSE was related to an improvement in post-operative LVEF; ΔLVEF of ≥6% during DSE predicted an improvement in post-operative LVEF, with a sensitivity and specificity of 80% and 85%, respectively. Conclusions: DSE may be a helpful tool for predicting post-operative reverse remodeling in patients with severe AR and moderately reduced LVEF.

scholarly journals Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation

2019 ◽  
Vol 20 (10) ◽  
pp. 1105-1111
Author(s):  
E Mara Vollema ◽  
Gurpreet K Singh ◽  
Edgard A Prihadi ◽  
Madelien V Regeer ◽  
See Hooi Ewe ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
Time Course ◽  
Pressure Overload ◽  
Volume Overload ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Lv Mass

Abstract Aims Pressure overload in aortic stenosis (AS) and both pressure and volume overload in aortic regurgitation (AR) induce concentric and eccentric hypertrophy, respectively. These structural changes influence left ventricular (LV) mechanics, but little is known about the time course of LV remodelling and mechanics after aortic valve surgery (AVR) and its differences in AS vs. AR. The present study aimed to characterize the time course of LV mass index (LVMI) and LV mechanics [by LV global longitudinal strain (LV GLS)] after AVR in AS vs. AR. Methods and results Two hundred and eleven (61 ± 14 years, 61% male) patients with severe AS (63%) or AR (37%) undergoing surgical AVR with routine echocardiographic follow-up at 1, 2, and/or 5 years were evaluated. Before AVR, LVMI was larger in AR patients compared with AS. Both groups showed moderately impaired LV GLS, but preserved LV ejection fraction. After surgery, both groups showed LV mass regression, although a more pronounced decline was seen in AR patients. Improvement in LV GLS was observed in both groups, but characterized by an initial decline in AR patients while LV GLS in AS patients remained initially stable. Conclusion In severe AS and AR patients undergoing AVR, LV mass regression and changes in LV GLS are similar despite different LV remodelling before AVR. In AR, relief of volume overload led to reduction in LVMI and an initial decline in LV GLS. In contrast, relief of pressure overload in AS was characterized by a stable LV GLS and more sustained LV mass regression.

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