Left ventricular performance in aortic valve replacement.

Abstract:

:We analyzed the mid-term left ventricular (LV) performance after aortic valve replacement (AVR). We measured LV contractility (end-systolic elastance: Ees), afterload (effective arterial elastance: Ea) and efficiency (ventriculoarterial coupling: Ea/Ees; ratio of stroke work and pressure-volume area: SW/PVA) based on transthoracic echocardiography data obtained before, after and approximately 1 year after isolated AVR in 263 patients with aortic stenosis (AS group; n=116), aortic regurgitation (AR group; n=93) or aortic stenosis and regurgitation (ASR group; n=54). The LV volume was calculated by the Teichholz M-mode method. Ees and Ea were approximated as follows: Ees=mean blood pressure/minimal LV volume; Ea=systolic blood pressure/(maximal LV volume-minimal LV volume). Thereafter, Ea/Ees and SW/PVA were calculated. Arterial blood pressure was measured using manchette methods. Ees and Ea decreased after AVR in the AS group, but increased in the AR group. Ea/Ees and SW/PVA worsened after AVR in the AR group, but improved during a 1-year period after AVR in all groups. Contrasting effects of AVR on LV contractility and afterload between AS and AR were clearly demonstrated. The mid-term LV contractility and efficiency after AVR were excellent and satisfactory. However, LV efficiency worsened early after AVR in AR patients.

authors

Tanoue Y,Maeda T,Oda S,Baba H,Oishi Y,Tokunaga S,Nakashima A,Tominaga R

doi

10.1510/icvts.2009.202309

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

255-9

issue

2

eissn

1569-9293

issn

1569-9285

pii

icvts.2009.202309

journal_volume

9

pub_type

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