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Moderate chronic kidney disease and left ventricular hypertrophy after aortic valve replacement for aortic valve

Umberto Benedetto1, Giovanni Melina, Emiliano Angeloni

  • 1Cardiac Surgery Department, University of Rome La Sapienza, Policlinico S. Andrea, Via di Grottarossa 1039 Rome, Italy. u2benedetto@libero.it

The Journal of Thoracic and Cardiovascular Surgery
|March 23, 2010
PubMed

Insights

Moderate chronic kidney disease hinders left ventricular mass regression after aortic valve replacement for aortic stenosis. Patients with moderate kidney disease also face a higher risk of developing congestive heart failure post-surgery.

Area of Science:

  • Cardiology
  • Nephrology
  • Cardiovascular Surgery

Background:

  • Left ventricular hypertrophy regression is a key goal after aortic valve replacement for aortic stenosis.
  • Moderate chronic kidney disease (CKD) is linked to increased left ventricular hypertrophy in hypertensive patients.
  • The impact of moderate CKD on left ventricular remodeling in aortic stenosis is not well understood.

Purpose of the Study:

  • To investigate if moderate chronic kidney disease affects left ventricular mass regression in patients undergoing isolated aortic valve replacement for aortic stenosis.

Main Methods:

  • 157 patients with aortic stenosis underwent assessment of left ventricular mass regression 18 months post-aortic valve replacement.
  • 73 patients (46%) had moderate CKD (glomerular filtration rate 30-60 mL/min/1.73 m²).
  • Patients with glomerular filtration rate <30 mL/min/1.73 m² were excluded.

Main Results:

  • Left ventricular mass decreased significantly post-surgery in both groups, but remained higher in patients with moderate CKD (61 ± 18 vs. 50 ± 16 g/m².⁷).
  • Baseline glomerular filtration rate correlated with left ventricular mass at 18 months and the extent of regression, even after adjusting for confounders.
  • Moderate CKD was associated with an increased incidence of congestive heart failure symptoms (adjusted hazard ratio, 1.9).

Conclusions:

  • Patients with aortic stenosis and moderate CKD exhibit reduced left ventricular mass regression after aortic valve replacement.
  • Concomitant moderate CKD is linked to a higher risk of developing congestive heart failure following aortic valve replacement surgery.
Abstract

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