Left ventricular diastolic dysfunction late after aortic valve replacement in patients with aortic stenosis

被引:43
作者
Gjertsson, P [1 ]
Caidahl, K
Bech-Hanssen, O
机构
[1] Sahlgrens Univ Hosp, Dept Clin Physiol, Cardiovasc Inst, Gothenburg, Sweden
[2] Karolinska Inst, Stockholm, Sweden
关键词
D O I
10.1016/j.amjcard.2005.04.052
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patients with severe aortic stenosis (AS) are known to have increased left ventricular (LV) mass and diastolic dysfunction. It has been suggested that LV mass and diastolic function normalize after aortic valve replacement (AVR). In the present study, change in LV mass index and diastolic function 10 years after AVR for AS was evaluated. Patients who underwent AVR from 1991 to 1993 (n = 57; mean age 67 8.6 years at AVR, 58% men) were investigated with Doppler echocardiography preoperatively and 2 and 10 years postoperatively. Diastolic function was evaluated by integrating mitral and pulmonary venous flow data. Expected values for each patient, taking age into consideration, were defined using a control group (n = 7 1; age range 18 to 83 years). Patients were classified into 4 types: normal diastolic function (type A), mild diastolic dysfunction (type B), moderate diastolic dysfunction (type Q, and severe diastolic dysfunction (type D). There was a reduction in IN mass index between the preoperative (161 +/- 39 g/m(2)) and 2-year follow-up (114 28 g/m(2)) examinations (p < 0.0001), but no further reduction was seen at 10 years (119 +/- 49 g/m(2)). The percentage of patients with increased IN mass index decreased from 83% preoperatively to 29% at 2-year follow-up (p < 0.001). The percentage of patients with moderate to severe LV diastolic dysfunction (types C and D) was unchanged between the preoperative (7%) and 2-year follow-up (13%) examinations (p = 0.27). The percentage of patients increased at 10-year follow-up to 61% (p < 0.0001). In conclusion, this reveals the development of moderate to severe diastolic dysfunction 10 years after AVR, despite a reduction in the LV mass index. (c) 2005 Elsevier Inc. All rights reserved.
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收藏
页码:722 / 727
页数:6
相关论文
共 22 条
[1]   RELATION OF TRANSMITRAL FLOW VELOCITY PATTERNS TO LEFT-VENTRICULAR DIASTOLIC FUNCTION - NEW INSIGHTS FROM A COMBINED HEMODYNAMIC AND DOPPLER ECHOCARDIOGRAPHIC STUDY [J].
APPLETON, CP ;
HATLE, LK ;
POPP, RL .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1988, 12 (02) :426-440
[2]   AGE-RELATED INCREASE IN SYSTOLIC FRACTION OF PULMONARY VEIN FLOW VELOCITY-TIME INTEGRAL FROM TRANSESOPHAGEAL DOPPLER ECHOCARDIOGRAPHY IN SUBJECTS WITHOUT CARDIAC DISEASE [J].
ARAKAWA, M ;
AKAMATSU, S ;
TERAZAWA, E ;
DOHI, S ;
MIWA, H ;
KAGAWA, K ;
NISHIGAKI, K ;
ITO, Y ;
HIRAKAWA, S .
AMERICAN JOURNAL OF CARDIOLOGY, 1992, 70 (13) :1190-1194
[3]   Reference Doppler echocardiographic values for St. Jude Medical, Omnicarbon, and Biocor prosthetic valves in the aortic position [J].
Bech-Hanssen, O ;
Wallentin, I ;
Larsson, S ;
Caidahl, K .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 1998, 11 (05) :466-477
[4]   Influence of aortic valve replacement, prosthesis type, and size on functional outcome and ventricular mass in patients with aortic stenosis [J].
Bech-Hanssen, O ;
Caidahl, K ;
Wall, B ;
Mykén, P ;
Larsson, S ;
Wallentin, I .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1999, 118 (01) :57-65
[5]   GENDER DIFFERENCES IN CLINICAL-EVALUATION AND TRIAGE IN CORONARY-ARTERY DISEASE [J].
BERGELSON, BA ;
TOMMASO, CL .
CHEST, 1995, 108 (06) :1510-1513
[6]   Equity in access to exercise tolerance testing, coronary angiography, and coronary artery bypass grafting by age, sex and clinical indications [J].
Bowling, A ;
Bond, M ;
McKee, D ;
McClay, M ;
Banning, AP ;
Dudley, N ;
Elder, A ;
Martin, A ;
Blackman, I .
HEART, 2001, 85 (06) :680-686
[7]   ECHOCARDIOGRAPHIC ASSESSMENT OF LEFT-VENTRICULAR HYPERTROPHY - COMPARISON TO NECROPSY FINDINGS [J].
DEVEREUX, RB ;
ALONSO, DR ;
LUTAS, EM ;
GOTTLIEB, GJ ;
CAMPO, E ;
SACHS, I ;
REICHEK, N .
AMERICAN JOURNAL OF CARDIOLOGY, 1986, 57 (06) :450-458
[8]   Four year follow up of aortic valve replacement for isolated aortic stenosis: a link between reduction in pressure overload, regression of left ventricular hypertrophy, and diastolic function [J].
Ikonomidis, I ;
Tsoukas, A ;
Parthenakis, F ;
Gournizakis, A ;
Kassimatis, A ;
Rallidis, L ;
Nihoyannopoulos, P .
HEART, 2001, 86 (03) :309-316
[9]   Feasibility of obtaining pulmonary venous flow velocity in cardiac patients using transthoracic pulsed wave Doppler technique [J].
Jensen, JL ;
Williams, FE ;
Beilby, BJ ;
Johnson, BL ;
Miller, LK ;
Ginter, TL ;
TomaselliMartin, G ;
Appleton, CP .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 1997, 10 (01) :60-66
[10]   Regression of left ventricular mass one year after aortic valve replacement for pure severe aortic stenosis [J].
Kühl, HP ;
Franke, A ;
Puschmann, D ;
Schöndube, FA ;
Hoffmann, R ;
Hanrath, P .
AMERICAN JOURNAL OF CARDIOLOGY, 2002, 89 (04) :408-413