Why the study?
Aortic valve disease causes left ventricular hypertrophy and functional changes, and this study aimed to assess early LV remodeling after AVR in patients with severe aortic stenosis and/or moderate-to-severe aortic regurgitation.
Does aortic valve replacement improve early left ventricular remodeling and mass regression in patients with severe aortic valve disease?
Does aortic valve replacement improve early left ventricular remodeling and mass regression in patients with severe aortic valve disease?
Aortic valve replacement leads to significant and rapid regression of left ventricular mass index as early as 1 week postoperatively, with maximal early reduction observed at 6 weeks.
Answers are grounded in this paper and cite their sources.
Rapid early LVMI regression post-AVR may occur; hypothesis-generating and leaves open outcome impact in larger cohorts.
Background: Aortic valve disease leads to eccentric or concentric left ventricular (LV) hypertrophy and changes in the left ventricle function. The goal of aortic valve replacement (AVR) is to alleviate the pressure and volume overload on the left ventricle, allowing myocardial remodeling and regression of LV mass. Objectives: The objective of this study was to assess early LV remodeling in patients with severe aortic valve stenosis and/or moderate-to-severe aortic regurgitation after AVR. Materials and Methods: This prospective study was conducted in the department of cardiovascular and thoracic surgery between January 2015 and February 2016. All patients undergoing AVR exclusively over 1 year were included in the study. Patients were assessed at 1 week, 6 weeks, 3 months, and 6 months after AVR by transthoracic echocardiography. Peak and mean pressure gradients across aortic valve, LV ejection fraction, fractional shortening, LV dimensions, and LV mass along with other parameters were measured in the pre- and postoperative period. Results: A total of 33 patients with different lesions who underwent AVR were evaluated. All but one child (aged 12 years) were adults with a median age of 52 years ± 14.6 years including 21 males and 12 females. The LV mass index (LVMI) regression occurred over time in all cases. Mean LVMI decreased to 149.20 ± 53.7 g/m2 at 1 week and 120.8 ± 45.49 g/m2 at 6 weeks of AVR from its baseline value of 180.8 ± 58.9 g/m2 (P < 0.001). Six patients who were followed up to 1 year had mean LVMI 122.46 ± 50.0 g/m2. Conclusion: Marked reduction in LV mass was discerned after AVR as early as 1 week and further reduction continued up to 6 weeks; however, regression thereafter was not statistically significant.
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Mehta et al. (2021) studied this question.
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