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Clinical value of regression of electrocardiographic left ventricular hypertrophy after aortic valve replacement

Sayuri Yamabe1, Yoshihiro Dohi2, Akifumi Higashi1

  • 1Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-0037, Japan.

Heart and Vessels
|November 5, 2015
PubMed

Insights

Regression of electrocardiographic left ventricular hypertrophy (ECG-LVH) after aortic valve replacement (AVR) indicates reverse remodeling. Sokolow-Lyon voltage decrease after AVR reflects reduced left ventricular mass and dimensions, serving as a marker for successful treatment.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiac Surgery

Background:

  • Severe aortic stenosis often leads to electrocardiographic left ventricular hypertrophy (ECG-LVH).
  • Aortic valve replacement (AVR) is a standard treatment for severe aortic stenosis.
  • The Sokolow-Lyon voltage criterion (SV1 + RV5/6) is widely used to diagnose ECG-LVH.

Purpose of the Study:

  • To investigate if the regression of Sokolow-Lyon voltage after AVR correlates with echocardiographic evidence of left ventricular reverse remodeling.
  • To identify echocardiographic predictors of ECG-LVH regression following AVR.

Main Methods:

  • A cohort of 129 patients with severe aortic stenosis undergoing AVR was analyzed.
  • 38 patients with preoperative ECG-LVH (SV1 + RV5/6 ≥ 3.5 mV) were included.
  • Electrocardiography and echocardiography were performed pre- and 1-year post-AVR.

Main Results:

  • ECG-LVH regression was observed in 19 patients.
  • The ECG-LVH regression group showed significantly greater reductions in left ventricular mass index and dimensions compared to the non-regression group.
  • Independent predictors of ECG-LVH regression included decreased left ventricular mass index, end-diastolic dimension, and end-systolic dimension.

Conclusions:

  • Regression of ECG-LVH after AVR is associated with significant left ventricular reverse remodeling.
  • Sokolow-Lyon voltage regression serves as a valuable non-invasive marker for assessing the impact of AVR on left ventricular structure.
  • ECG-LVH regression provides an estimation of the extent of reverse remodeling achieved post-AVR.

Keywords:
Aortic stenosisAortic valve replacementElectrocardiogramLeft ventricular hypertrophyReverse remodeling

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