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Left ventricular mass regression following aortic valve replacement with mechanical valves

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objective

The degree of Left Ventricular Mass Index (LVMI) regression following aortic valve replacement correlates with long-term survival. This study aims to assess the extent of LVMI regression at 3 months following aortic valve replacement (AVR) with different types and sizes of mechanical valves in rheumatic aortic valve disease.

Methods

The LVMI regression was studied in 34 consecutive patients, undergoing elective AVR for rheumatic aortic stenosis and/or regurgitation. They were grouped in A and B, matched in age, body surface area and pre-operative LVMI, receiving respectively a tilting disc and a bileaflet mechanical valve. The LVMI was calculated by M-mode echocardiography using the Devereux' formula pre-operatively and three months post-operatively. The trend of LVMI reduction was compared between the two groups and amongst the patients with stenotic, regurgitant and mixed aortic valve, pathologies; and receiving different sizes of valves.

Results

The mean preoperative LVMI was 199g±79.5 g/m2. At three months post aortic valve replacement, the mean LVMI was 130g±49.0 g/m2. There was a significant reduction of LVMI post-operatively (p=0.001) at three months follow-up. The extent of LVMI regression following surgery amongst the groups A and B did not vary significantly (p=0.92). The extent of LVMI regression did not vary significantly in patients with different aortic valve pathology nor with different sizes of the valves implanted.

Conclusions

There is a significant early LVMI regression following aortic valve replacement in rheumatic aortic valve disease. The type and the size of the mechanical prosthesis or the rheumatic pathology do not appear to influence this regression.

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References

  1. Spann JF, Bove AA, Natarajan G, Kreulen T. Ventricular performance, pump function, and compensatory mechanisms in patients with aortic stenosis. Circulation. 1980; 62: 576–82.

    PubMed  CAS  Google Scholar 

  2. Wisenbaugh T, Booth D, DeMaria A, Nissen S, Waters J. Relationship of contractile state to ejection performance in patients with chronic aortic valve disease. Circulation. 1986; 73: 47–53.

    PubMed  CAS  Google Scholar 

  3. Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. Prognostic implications of echocardiographically determined left ventricular mass in Framingham Heart study. N Engl J Med. 1990; 322: 1561–66.

    Article  PubMed  CAS  Google Scholar 

  4. Haider AW, Larson MG, Benjamin EJ, Levy D. Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death. J Am Coll Cardiol. 1998; 32: 1454–59.

    Article  PubMed  CAS  Google Scholar 

  5. Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommendations regarding quantitation in M-mode echocardiography: Results of a survey of echocardiographic measurements. Circulation. 1978; 58: 1072–83.

    PubMed  CAS  Google Scholar 

  6. Devereux RB, Reichek N. Echocardiographic determination of LV mass in man: anatomic validation of the method. Circulation. 1977; 55: 613–18.

    PubMed  CAS  Google Scholar 

  7. Mehta RH, Brukman D, Das S, Tsai T, Russman P, Karavite D, Monaghan H, Sonnad S, Shea MJ, Eagle KA, Deeb G M. Implications of increased left ventricular mass index on inhospital outcomes in patients undergoing aortic valve surgery. J Thorac Cardiovasc Surg 2001; 122: 919–28.

    Article  PubMed  CAS  Google Scholar 

  8. Jin XY, Zhang ZM, Gibson DG, Yacoub MH, Pepper JR. Effects of valve substitute on changes in left ventricular function and hypertrophy after aortic valve replacement. Ann Thorac Surg 1996; 62: 683–90.

    Article  PubMed  CAS  Google Scholar 

  9. Maselli D, Pizio R, Bruno LP, DiBella I, DeGasperis C. Left ventricular mass reduction after aortic valve replacement: homografts, stentless and stented valves. Ann Thorac Surg 1999; 67: 966–71.

    Article  PubMed  CAS  Google Scholar 

  10. Walther T, Falk V, Langerbartels G, Kruger M, Schilling L, Diegeler A, Gummert J, Autschbach R, Mohr FW. Regression of left vemtricular hypertrophy after stentless versus conventional aortic valve replacement. Semin Thorac Cardiovasc Surg 1999; 11 (4 Suppl 1): 18–21.

    PubMed  CAS  Google Scholar 

  11. Basarir S, Islamoglu F, Ozkisacik E, Atay Y, Boga M, Bakalim T, Ozbaran M, Telli A. Comparative analysis of left ventricular haemodynamics and hypertrophy after aortic valve replacement with homografts and mechanical valves. J Heart Valve Dis 2000; 9: 45–52.

    PubMed  CAS  Google Scholar 

  12. Kleine P, Perthel M, Nygaard H, Hansen SB, Paulsen PK, Lass J Medtronic Hall versus St Jude Medical mechanical aortic valve: downstream turbulences with respect to rotation in pigs. J Heart Valve Dis. 1998; 7: 548–55.

    PubMed  CAS  Google Scholar 

  13. Collins HW, Kronenberg MW, Byrd BF3rd. Reproducibility of left ventricular mass measurements by two-dimensional and M-mode echocardiography. J Am Coll Cardiol. 1989; 14: 672–6.

    Article  PubMed  CAS  Google Scholar 

  14. Sensky PR, Loubani M, Keal RP, Samani NJ, Sosnowski AW, Calinanes M. Does the type of prosthesis influence early left ventricular mass regression after aortic valve replacement? Assessment with magnetic resonance imaging. Am Heart J. 2003; 146: E13

    Article  PubMed  Google Scholar 

  15. Bech-Hanssen O, Caidahl K, Wall B, Myken P, Larsson S. Wallentin I. Influence of aortic valve replacement, prosthesis type, and size on functional outcome and ventricular mass in patients with aortic stenosis. J Thorac Cardiovasc. Surg. 1999; 118: 57–65.

    Article  PubMed  CAS  Google Scholar 

  16. Del Rizzo DF, Abdoh A, Cartier P, Doty D, Westaby S. Factors affecting left ventricular mass regression after aortic valve replacement with stentless valves. Semin Thorac Cardiovasc Surg. 1999; 11 (4 Suppl 1): 114–20.

    PubMed  Google Scholar 

  17. Tasca G, Brunelli F, Cirillo M, Amaducci A, Mhagna Z, Troise G, Quaini E. Mass regression in aortic stenosis after valve replacement with small size pericardial bioprosthesis. Ann Thorac Surg. 2003; 76: 1107–13.

    Article  PubMed  Google Scholar 

  18. De Carlo M, Milano AD, Nardi C, Mecozzi G, Bortolotti U. Serial Doppler echocardiographic evaluation of small-sized sorin bicarbon prostheses. J Thorac Cardiovasc Surg. 2003; 126: 337–43.

    Article  PubMed  Google Scholar 

  19. Lee JW, Choi KJ, Lee SG, Choo SJ, Kim JO, Kang DH, Song JK, Song MG. Left ventricular muscle mass regression after aortic valve replacement. J Korean Med Sci. 1999; 14: 511–19.

    PubMed  CAS  Google Scholar 

  20. Ozatik MA, Gol MK, Yildiz U, Goksel S, Yurdakok O, Yavas S, Tufekcioglu O, Sener E, Tasdemir O. Regression of left ventricular hypertrophy after aortic valve replacement to patients over 55 years old with different valve types. Med Sci. Monit. 2003; 9: CR55–60.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardio Vascular & Thoracic Surgery, KEM Hospital and Seth G S Medical College, 400012, Mumbai

    Ashutosh Singh M.Ch., Vidyut Kumar Sinha M.Ch., Jayant Khandekar M.Ch., Nandkishor Agrawal M.Ch., Anil Patwardhan M.Ch. &  Jagdish Kharideparkar M.Ch. (Professor & Chief of the Unit)

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  1. Ashutosh Singh M.Ch.
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  2. Vidyut Kumar Sinha M.Ch.
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  3. Jayant Khandekar M.Ch.
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  4. Nandkishor Agrawal M.Ch.
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  5. Anil Patwardhan M.Ch.
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  6. Jagdish Kharideparkar M.Ch.
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Correspondence to Jagdish Kharideparkar M.Ch..

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Singh, A., Sinha, V.K., Khandekar, J. et al. Left ventricular mass regression following aortic valve replacement with mechanical valves. Indian J Thorac Cardiovasc Surg 22, 121–125 (2006). https://doi.org/10.1007/s12055-006-0019-9

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  • DOI: https://doi.org/10.1007/s12055-006-0019-9

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