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Myocardial oxygen consumption in aortic valve disease with and without left ventricular dysfunction
J Schwitter1, F R Eberli, M Ritter
1Medical Policlinic, University Hospital, Zurich, Switzerland.
British Heart Journal
|February 1, 1992
Summary
Myocardial oxygen consumption in aortic valve disease is affected by hypertrophy and contractility. Successful valve replacement normalizes oxygen consumption, indicating reversible changes in mechanical efficiency.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Aortic valve disease often leads to left ventricular hypertrophy and altered contractility.
- Understanding the impact on myocardial oxygen consumption is crucial for patient management.
Purpose of the Study:
- To assess how hypertrophy and contractility affect myocardial oxygen consumption in aortic valve disease.
- To evaluate the impact of aortic valve replacement on these parameters.
Main Methods:
- A cohort analytical study involving 43 patients with aortic valve disease and 6 controls.
- Measured hemodynamic variables, left ventricular cineangiography, and coronary sinus blood flow.
- Utilized multiple regression analysis and analysis of covariance.
Main Results:
- Myocardial oxygen consumption correlated positively with stress-rate product and ejection fraction, and negatively with left ventricular muscle mass index.
- Oxygen consumption was higher in patients with hypertrophy and reduced ejection fraction compared to controls.
- Postoperative normalization of hypertrophy and contractility led to oxygen consumption levels similar to controls.
Conclusions:
- Hypertrophied ventricles, especially with decreased contractility, show increased mechanical efficiency in aortic valve disease.
- These alterations in mechanical efficiency are reversible after successful aortic valve replacement.