Regression of Left Ventricular Mass after Aortic Valve Replacement in Isolated Aortic Regurgitation

Background: The aim of our study was to assess the extent of regression of left ventricular mass after aortic valve replacement in isolated aortic regurgitation. Material and Method: Retrospective analysis of echocardiographic data was collected preoperative and postoperative 1 year. There were 20 patients (12 males, 8 females, mean age 55.8±11.8 years, mean body surface area 1.64±0.19 ㎡) with aortic regurgitation from 2002 through 2007. We studied the change of left ventricular ejection fraction, ventricular septum and left ventricular posterior wall thickness, and left vemtricular muscle index (LVMI). The control group was age matched with normal echocardiographic study results. Patients with combined surgery or infective endocarditis were excluded. Result: Seven cases of tissue valves and thirteen cases of mechanical valve were used. The valve sizes were 21 mm (3 cases), 23 ㎜ (13 cases) and 25 ㎜ (4 cases). The postoperative (125.5±42 g/㎡) LVMI has decreased than preoperative LVMI (212.3±80 g/㎡, p=0.000) but higher than that of control group (80.5±15.9 g/㎡, p=0.000). Postoperative septal wall (systolic/diastolic: 13.5±3.4 ㎜/17.1±4.1 ㎜) and left ventricular posterior wall (systolic/diastolic: 12.9±3.4 ㎜/16.7±3.4 ㎜) thickness were slightly decreased after the valve replacement but was not significantly different than preoperative levels. And postoperative interventricular septal wall and left ventricular posterior wall thickness (systolic/diastolic: 8.6±1.4 ㎜/12.1±1.7 ㎜, systolic/diastolic: 8.4±1.4/13.2±1.9) were higher than that of the control group (p＜0.001). Conclusion: The significant regression of LVMI after aortic valve replacement developed at postoperative one year but the level was higher than control group. The main cause of decreased LVMI is decreased in left ventricular dimension.