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Failure of left ventricular hypertrophy to regress after surgery for aortic valve stenosis

Jonathan Lessick1, Diab Mutlak, Walter Markiewicz

  • 1Department of Cardiology, Rambam Medical Center, Haifa, Israel.

Echocardiography (Mount Kisco, N.Y.)
|August 14, 2002
PubMed

Insights

Successful regression of left ventricular hypertrophy after aortic valve surgery is not fully predictable. Absence of regression indicates a poor long-term prognosis for patients with aortic stenosis.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Left ventricular (LV) hypertrophy often regresses after aortic stenosis (AS) surgery, but failure to regress occurs in a significant number of patients.
  • The extent, reasons, and clinical significance of persistent LV hypertrophy post-AS surgery remain unclear.

Purpose of the Study:

  • To investigate factors influencing left ventricular hypertrophy regression after aortic valve surgery.
  • To determine the prognostic significance of failed LV hypertrophy regression.

Main Methods:

  • Compared 43 patients before and after aortic valve surgery, divided into those with (Group A, n=30) and without (Group B, n=13) LV hypertrophy regression.
  • Analyzed preoperative echocardiographic data, clinical status, and operative factors.
  • Followed patients for adverse outcomes including congestive heart failure (CHF) hospitalization and death.

Main Results:

  • Group B (no regression) had more patients in NYHA Class IV and a higher incidence of prior myocardial infarction preoperatively.
  • Postoperatively, Group B showed larger LVs, reduced systolic function, and significantly worse outcomes (23% mortality, 38% CHF) compared to Group A (0% mortality, 4% CHF).
  • Previous myocardial infarction and lower percent LV mass reduction independently predicted adverse events.

Conclusions:

  • Predicting successful LV mass regression before aortic valve surgery is challenging.
  • Absence of LV mass regression is strongly associated with a poor long-term prognosis in patients undergoing surgery for aortic stenosis.
Abstract

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