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Influence of prosthesis size and left ventricular mass on left ventricular diastolic reserve in patients with aortic

J R Gonzalez-Juanatey1, M Vega Fernandez, F Gude

  • 1Department of Cardiology, Hospital Clinico Universitario de Santiago, Faculty of Medicine, Santiago de Compostela, Spain.

The Journal of Heart Valve Disease
|October 18, 2001
PubMed

Insights

Aortic valve replacement for stenosis provides considerable long-term diastolic reserve, unaffected by prosthetic valve size. Left ventricular diastolic function during exertion remains similar to normal hearts post-surgery.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Aortic stenosis necessitates aortic valve replacement (AVR).
  • Long-term assessment of left ventricular (LV) diastolic reserve after AVR is crucial.
  • The impact of prosthetic valve size and type on LV function requires investigation.

Purpose of the Study:

  • To determine the influence of prosthetic valve size and LV mass on long-term LV diastolic reserve in patients undergoing AVR for stenosis.
  • To evaluate the functional outcomes of different prosthetic valve types (pericardial bioprostheses vs. bileaflet mechanical prostheses).

Main Methods:

  • Seventy-four patients (mean age 64 years) post-AVR with 19, 21, or 23 mm valves were studied.
  • Doppler echocardiography was performed at rest and peak effort, 12-47 months after surgery.
  • Analysis included heart rate, blood pressure, cardiac output, transvalvular pressure drops, and valve areas.

Main Results:

  • All patients demonstrated significant increases in heart rate, blood pressure, and cardiac output during effort.
  • Effort also significantly altered transvalvular pressure gradients and valve areas.
  • Mean diastolic reserve (29.3 ml) and stroke volume reserve (23.2 ml) showed no significant differences between valve types or sizes.

Conclusions:

  • Diastolic reserve is considerable and independent of valve size approximately one year after AVR for stenosis.
  • Despite persistent LV hypertrophy, LV diastolic function during effort is comparable to that of a normal heart.
  • These findings support the efficacy of AVR in restoring cardiac function irrespective of prosthetic valve size.
Abstract

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