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[Heart failure in valvular heart disease]

H Shintani1, H Matsuda

  • 1Osaka University Medical School.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|May 1, 1993
PubMed
Summary

Heart failure severity in chronic valvular heart disease is best assessed by evaluating left ventricular pump function and myocardial contractility, not just clinical symptoms. This approach aids in determining optimal surgical timing for improved patient outcomes.

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Area of Science:

  • Cardiology and Cardiovascular Surgery
  • Heart Failure Pathophysiology
  • Valvular Heart Disease Management

Context:

  • Clinical heart failure presentation is influenced by the development rate and compensatory mechanisms.
  • Chronic valvular heart diseases often allow gradual adaptation through mechanisms like cardiac hypertrophy.
  • Effective treatment aims to improve prognosis and quality of life for chronic heart failure patients.

Purpose:

  • To evaluate left ventricular pump and contractile function before and after surgery for valvular diseases.
  • To estimate the reversibility of left ventricular systolic function post-surgery.
  • To determine optimal surgical timing for patients with chronic valvular heart diseases.

Summary:

  • Assessed myocardial contractility using ejection fraction vs. end-systolic volume and end-systolic wall stress/end-systolic volume index (ESS/ESVI).
  • Evaluated changes in left ventricular function pre- and post-operative correction of valvular diseases.
  • Reduced pump function and myocardial contractility are key indicators of heart failure severity, especially during compensation.

Impact:

  • Highlights the importance of objective functional assessments over subjective clinical symptoms for heart failure severity in valvular disease.
  • Provides a method for determining optimal surgical timing, potentially improving surgical outcomes.
  • Contributes to better management strategies for chronic heart failure secondary to valvular abnormalities.

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