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Impact of moderate coronary atherosclerosis on long-term left ventricular remodeling after aortic valve replacemen

Jose Antonio Linares Vicente1, Isaac Lacambra Blasco, Pilar Portero Perez

  • 1Department of Cardiology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain. joselinares1979@hotmail.com

Cardiology Journal
|June 11, 2011
PubMed

Insights

Moderate coronary atherosclerosis impacts ventricular remodeling after aortic valve replacement. Patients without coronary issues showed better left ventricular (LV) mass and dimension reduction post-surgery.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Vascular Biology

Background:

  • The impact of coronary atherosclerosis (CA+) on ventricular remodeling after aortic valve replacement (AVR) for aortic stenosis (AS) remains unclear.
  • This study investigates the long-term effects of moderate, unaddressed coronary atherosclerosis on left ventricular (LV) remodeling post-AVR.

Purpose of the Study:

  • To evaluate the influence of non-revascularized moderate coronary atherosclerosis on long-term left ventricular remodeling following aortic valve replacement for isolated aortic stenosis.

Main Methods:

  • Coronary artery disease was assessed via coronariography in 66 patients undergoing AVR.
  • Morphological and functional LV data were evaluated using echocardiography preoperatively and at long-term follow-up (3 ± 1.2 years).

Main Results:

  • Patients without coronary atherosclerosis exhibited more significant hypertrophy regression and greater reverse remodeling of LV mass index (-55.8 ± 36 g/m² vs -28.4 ± 34 g/m², p=0.004).
  • Greater reduction in LV dimensions (LVEDD: -4.1 ± 7.4 mm vs -2.2 ± 8.3 mm, p=0.04) and wall thickness (IVS: -3.3 ± 2.6 mm vs -1.6 ± 2.2 mm, p=0.01; PWT: -2.1 ± 2.1 mm vs 0.6 ± 2.1 mm, p=0.012) was observed in patients without CA+.

Conclusions:

  • Unaddressed moderate coronary atherosclerosis is associated with reduced long-term left ventricular hypertrophy regression after AVR for AS.
  • Coronary atherosclerosis negatively impacts the absolute reverse remodeling of LV mass index, LVEDD, IVS, and PWT post-AVR.
Abstract

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