Left ventricular mass regression in patients without patient–prosthesis mismatch after aortic valve replacement for aortic stenosis

Abstract

Objectives

The relationship between the degree of a postoperative effective orifice area and temporal regression of a left ventricular mass after aortic valve replacement for aortic stenosis is unclear in patients without patient–prosthesis mismatch. We therefore investigated the relationship and independent predictors of left ventricular mass regression.

Methods

Among 307 consecutive patients who underwent aortic valve replacement for aortic stenosis between 2008 and 2013, 223 patients receiving a periodic inspection by echocardiography for at least 3 consecutive years after surgery without patient–prosthesis mismatch were enrolled in the present study. Temporal regression of left ventricular mass index was compared between two groups that were classified equally according to effective orifice area index obtained at a 1-week postoperative echocardiographic examination: < 1.20 cm2/m2 (n = 112) and > 1.20 cm2/m2 (n = 111). We also determined the predictors affecting left ventricular mass regression.

Results

No difference existed in the preoperative left ventricular mass index between the two groups (p = 0.431). Temporal regression of the left ventricular mass index was similar in the two groups. The independent predictors of left ventricular mass regression were male gender (p = 0.007) and preoperative left ventricular mass index (p = 0.003), but valve size was not (p = 0.641).

Conclusions

There was no relationship between the degree of postoperative effective orifice area and temporal regression of the left ventricular mass in patients without patient–prosthesis mismatch. The independent predictors of left ventricular mass regression were male gender and preoperative left ventricular mass index.

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References

  1. 1.

    Petereson KL, Ricci D, Tsuji J, Sasayama S, Ross J Jr. Evaluation of chamber and myocardial compliance in pressure overload hypertrophy. Eur J Cardiol. 1978;7:195–211.

    Google Scholar 

  2. 2.

    Ali A, Patel A, Ali Z, Abu-Omar Y, Saeed A, Athanasiou T, et al. Enhanced left ventricular mass regression after aortic valve replacement in patients with aortic stenosis is associated with improved long-term survival. J Thoracic Cardiovasc Surg. 2011;142:285–91.

    Article  Google Scholar 

  3. 3.

    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;11:114–20.

    PubMed  Google Scholar 

  4. 4.

    Tao K, Sakata R, Iguro Y, Ueno M, Tanaka Y, Otsuji Y, et al. Impact of valve prosthesis-patient mismatch on intermediate-term outcome and regression of left ventricular mass following aortic valve replacement with mechanical prosthesis. J Card Surg. 2007;22:486–92.

    Article  Google Scholar 

  5. 5.

    Tasca G, Brunelli F, Cirillo M, Dalla Tomba M, Mhagna Z, Troise G, et al. Impact of the improvement of valve area achieved with aortic valve replacement on the regression of left ventricular hypertrophy in patients with pure aortic stenosis. Ann Thorac Surg. 2005;79:1291–6.

    Article  Google Scholar 

  6. 6.

    Tasca G, Brunelli F, Cirillo M, Dalla Tomba M, Mhagna Z, Troise G, et al. Impact of valve prosthesis-patient mismatch on left ventricular mass regression following aortic valve replacement. Ann Thorac Surg. 2005;79:505–10.

    Article  Google Scholar 

  7. 7.

    Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986;57:450–8.

    CAS  Article  Google Scholar 

  8. 8.

    Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and Champer Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a blanch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–633.

    Article  Google Scholar 

  9. 9.

    Christakis GT, Joyner CD, Morgan CD, Fremes SE, Buth KJ, Sever JY, et al. Left Ventricular mass regression early after aortic valve replacement. Ann Thorac Surg. 1996;62:1084–9.

    CAS  Article  Google Scholar 

  10. 10.

    Ruel M, Al-faleh H, Kulik A, Chan KL, Mesana TG. Burwash IG Prosthesis-patient mismatch after aortic valve replacement predominantly affects patients with preexisting left ventricular dysfunction: effect on survival, freedom from heart failure, and left ventricular mass regression. J Thorac Cardiovasc Surg. 2006;131:1036–44.

    Article  Google Scholar 

  11. 11.

    Rohde LE, Zhi G, Aranki SF, Beckel NE, Lee RT. Reimod SC Gender-associated differences in left ventricular geometry in patients with aortic valve disease and effect of distinct overload subsets. Am J Cardiol. 1997;80:475–80.

    CAS  Article  Google Scholar 

  12. 12.

    Lim E, Ali A, Theodorou P, Sousa I, Ashrafian H, Chamogeorgakis T, et al. Longitudinal study of the profile and predictors of left ventricular mass regression after stentless aortic valve replacement. Ann Thorac Surg. 2008;85:2026–9.

    Article  Google Scholar 

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Correspondence to Kohei Hachiro.

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Hachiro, K., Kinoshita, T., Asai, T. et al. Left ventricular mass regression in patients without patient–prosthesis mismatch after aortic valve replacement for aortic stenosis. Gen Thorac Cardiovasc Surg 68, 227–232 (2020). https://doi.org/10.1007/s11748-019-01188-2

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Keywords

  • Aortic valve replacement
  • Aortic stenosis
  • Left ventricular mass regression
  • Patient–prosthesis mismatch
  • Effective orifice area