Abstract:
OBJECTIVES:This study sought to determine the outcome of aortic valve replacement for aortic regurgitation complicated by extreme left ventricular dilation. BACKGROUND:Aortic valve replacement has been recommended in aortic regurgitation with extreme left ventricular dilation (diastolic dimension >/= 80 mm), but extreme left ventricular dilation raises concern about irreversible left ventricular dysfunction. METHODS:Thirty-one patients with a preoperative echocardiographic diastolic dimension >/= 80 mm (group 1) undergoing operation for severe isolated aortic regurgitation between 1980 and 1989 were compared with 188 patients with a diastolic dimension <80 mm operated on during the same period (group 2). RESULTS:Preoperatively, extreme left ventricular dilation was seen only in male patients and was associated with a reduced ejection fraction (43 +/- 12% vs. 53 +/- 11% [mean +/- SD], p < 0.0001). The postoperative outcome of group 1 was compared with that of male patients in group 2 (group 2M, n = 144). The operative mortality rates for groups 1 and 2M were 0% and 5.6%, respectively (p = 0.35). Late survival in operative survivors was similar in groups 1 and 2M, but compared with expected survival, an excess mortality was observed for group 1 (p = 0.024). Preoperative ejection fraction, but not diastolic dimension, independently predicted late survival and postoperative ejection fraction. Postoperatively, groups 1 and 2M showed a similar improvement in ejection fraction, but persistent left ventricular enlargement was more frequent in group 1. CONCLUSIONS:Extreme left ventricular dilation due to aortic regurgitation is observed in male patients and is frequently associated preoperatively with a reduced ejection fraction but is not a marker of irreversible left ventricular dysfunction. Operative risk and late postoperative survival are acceptable in these patients, although a late excess mortality, predicted best by preoperative ejection fraction, is observed. Therefore, extreme left ventricular dilation is not a contraindication to operation, which should be performed before left ventricular dysfunction occurs.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Klodas E,Enriquez-Sarano M,Tajik AJ,Mullany CJ,Bailey KR,Seward JBdoi
10.1016/0735-1097(95)00525-0subject
Has Abstractpub_date
1996-03-01 00:00:00pages
670-7issue
3eissn
0735-1097issn
1558-3597pii
0735-1097(95)00525-0journal_volume
27pub_type
杂志文章abstract::The feasibility and effectiveness of low energy synchronous transcatheter cardioversion of atrial flutter and fibrillation were examined in dogs with talc-induced pericarditis. A conventional electrode catheter was positioned transvenously in the right atrial appendage. Atrial flutter/fibrillation was induced by using...
journal_title:Journal of the American College of Cardiology
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abstract:OBJECTIVES:We compared left ventricular (LV) systolic and diastolic function during right ventricular (RV), LV, and biventricular (BiV) pacing in patients with narrow QRS duration with and without LV dysfunction. BACKGROUND:The optimal RV pacing lead location for patients with a standard indication for ventricular pac...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2006.04.099
更新日期:2006-10-17 00:00:00
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abstract:OBJECTIVES:This study sought to determine whether epicardial fat volume predicts coronary events in the general population. BACKGROUND:Epicardial adipose tissue (EAT) is suggested to promote plaque development in the coronary artery tree. METHODS:We quantified EAT volume in participants from the prospective populatio...
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pub_type: 杂志文章
doi:10.1016/j.jacc.2012.11.062
更新日期:2013-04-02 00:00:00
abstract::The feasibility of using a flexible, steerable angioscope to perform coronary angioscopy before and after percutaneous coronary angioplasty was tested. The microangioscope fits through an 8F coronary angioplasty guiding catheter and contains a multifiber viewing bundle incorporated into the body of a 4.3F balloon cath...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
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doi:10.1016/s0735-1097(83)80235-6
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abstract::Atrial natriuretic peptide hormone of cardiac origin, which is released in response to atrial distension and serves to maintain sodium homeostasis and inhibit activation of the renin-angiotensin-aldosterone system. Congestive heart failure is a clinical syndrome characterized by increased cardiac volume and pressure o...
journal_title:Journal of the American College of Cardiology
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更新日期:1993-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0735-1097(92)90201-w
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更新日期:1991-07-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2014-06-10 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2000-08-01 00:00:00
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更新日期:2017-11-28 00:00:00
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pub_type: 杂志文章
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更新日期:2005-03-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2018-12-11 00:00:00
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doi:10.1016/0735-1097(88)90478-0
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更新日期:2004-11-16 00:00:00
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更新日期:2011-12-06 00:00:00
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更新日期:2003-06-18 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:2004-03-17 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(88)90108-8
更新日期:1988-02-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2004-06-16 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(91)90549-o
更新日期:1991-11-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(97)82543-0
更新日期:1997-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00464-7
更新日期:1999-12-01 00:00:00