Late recurrence of left ventricular dysfunction after aortic valve replacement for severe chronic aortic regurgitation
| Autor: | Yoshihisa Nakagawa, Soichiro Enomoto, Sari Imamura, Masashi Amano, Kazuo Yamanaka, Makoto Miyake, Hirokazu Kondo, Toshihiro Tamura, Kazuaki Kaitani, Naoaki Onishi, Chisato Izumi, Yodo Tamaki |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Decreased ejection fraction medicine.medical_specialty Aortic Valve Insufficiency Regurgitation (circulation) 030204 cardiovascular system & hematology Severity of Illness Index Ventricular Dysfunction Left 03 medical and health sciences Early surgery 0302 clinical medicine Aortic valve replacement Recurrence Lv dysfunction Internal medicine Late Recurrence Humans Medicine Sinus rhythm 030212 general & internal medicine Aged Retrospective Studies Heart Valve Prosthesis Implantation Lv function business.industry Middle Aged medicine.disease Echocardiography Chronic Disease Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 224:240-244 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2016.09.032 |
| Popis: | Aortic valve replacement (AVR) for chronic aortic regurgitation (AR) with a decreased ejection fraction (EF) leads to improvement in left ventricular (LV) function, but there are no reports on late recurrence of LV dysfunction over long-term after AVR. This study aimed to identify frequency and predictors of late recurrent LV dysfunction after AVR.We retrospectively investigated 58 consecutive patients undergoing AVR for severe chronic AR and with follow-up echocardiography for5years after AVR. Late recurrence of LV dysfunction was defined as an EF of50% late after AVR and a 10% reduction in the EF compared with that observed at 1year after AVR.The mean follow-up period was 10.3±5.2years. The preoperative EF was50% in 21 (36%) patients, but it was normalized at 1year after AVR in all patients except for one. However, late recurrence of LV dysfunction developed in 7 (12%) of the 58 patients. These patients showed significantly higher LV end-diastolic and end-systolic diameters before and at 1year after AVR, a lower EF and relative wall thickness before AVR, a higher LV mass index at 1year after AVR, and a higher incidence of preoperative and postoperative atrial fibrillation than those without late recurrence.Late recurrent LV dysfunction may occur after AVR for severe chronic AR despite EF being once normalized. Early surgery proceeding remarkable LV enlargement and maintaining sinus rhythm are important for LV function over the long-term after AVR. |
| Databáze: | OpenAIRE |
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