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Left Ventricular Diastolic Function After Aortic Valve Replacement for Chronic Aortic Regurgitation

Wenrui Ma1, Wei Zhang1, Wei Shi1

  • 1Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

The Annals of Thoracic Surgery
|April 21, 2018
PubMed

Insights

Left ventricular diastolic dysfunction is common in severe aortic regurgitation but often improves after aortic valve replacement. However, an enlarged left ventricle may impede recovery of diastolic function.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Chronic severe aortic regurgitation frequently leads to left ventricular diastolic dysfunction.
  • Assessing diastolic function is crucial for managing patients undergoing aortic valve replacement.

Purpose of the Study:

  • To investigate the long-term evolution of left ventricular diastolic function after aortic valve replacement (AVR) for chronic severe aortic regurgitation.
  • To identify factors influencing diastolic function recovery and long-term outcomes post-AVR.

Main Methods:

  • 183 patients with severe aortic regurgitation underwent isolated AVR.
  • Diastolic function was assessed using left atrial volume index and average E/e' ratio.
  • Serial echocardiography tracked changes in diastolic function over long-term follow-up.

Main Results:

  • Preoperative diastolic dysfunction was present in 71.2% of patients; 43.3% improved post-AVR.
  • Age was the sole predictor of cardiac mortality.
  • Preoperative left ventricular end-diastolic volume index, NYHA class, and diastolic function grade predicted late heart failure.

Conclusions:

  • Left ventricular diastolic dysfunction is prevalent in severe aortic regurgitation and may improve after AVR.
  • Excessive left ventricular dilation pre-AVR can hinder diastolic function recovery.
Abstract

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