Key result
Surgical aortic valve replacement was associated with a 16.9% reduction in left ventricular mass index at 1 year, with baseline mass index being the only independent predictor of this reverse remodeling.
Why the study?
Aortic stenosis induces ventricular remodeling, and reverse remodeling after SAVR might impact prognosis, but its characterization, explanatory factors, and prognostic impact required assessment.
Does surgical aortic valve replacement induce left ventricular reverse remodeling in patients with severe aortic stenosis?
Observational (n=114)
No
Does surgical aortic valve replacement induce left ventricular reverse remodeling in patients with severe aortic stenosis?
Surgical aortic valve replacement for severe aortic stenosis induces significant left ventricular reverse remodeling at 1 year, which is primarily predicted by baseline left ventricular mass index.
May support SAVR for LV reverse remodeling in severe AS; leaves open causal effects and need for RCTs.
Context: Aortic stenosis (AS) induces ventricular remodeling. After surgical aortic valve replacement (SAVR), there is reverse remodeling (RR) that might impact patients’ prognosis. Aims: This study aims to characterize cardiac RR post-SAVR, determine possible explanatory factors of this phenomenon, and assess its prognostic impact. Methods: A retrospective observational study of 114 patients with severe AS who underwent SAVR between 2017 and 2021 and had echocardiographic follow-up 1 year after. A descriptive analysis of baseline characteristics of the patients was carried out, pre- and post-surgical comparisons. Factors associated with left ventricular RR (LVRR) and time to the occurrence of a major adverse cardiac event (MACE) were assessed. Results: A total of 114 patients were included, with a median age of 72 years. One-year post-SAVR the left ventricle mass index (LVMi) decreased 16.9% ( P < 0.01), the functional class improved (patients in New York Heart Association (NYHA) class I post-SAVR 57, 9% vs. patients in NYHA class I pre-SAVR 11, 4%; P < 0.01) and electrocardiographic criteria for hypertrophy were less common (19% post-SAVR vs. 43% pre-SAVR, P < 0.01). Basal LVMi was the only independent predictor of LVMi 1-year post-SAVR (B = 0.51 IC95% (0.34–0.68); P < 0.01). In the multivariate analysis, only age was associated with the occurrence of a MACE, hazard ratio = 1.11 ( P = 0.026). Conclusions: Results suggest that 1-year post-SAVR there is LVRR and basal LVMi is the only independent predictor of this phenomenon. Age is the only identified risk factor associated with the occurrence of a MACE, while no association was found between the latest and LVRR.
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Ferreira et al. (2025) conducted an observational in Severe aortic stenosis (n=114). Surgical aortic valve replacement vs. Preoperative baseline was evaluated on Left ventricular mass index (LVMi) (MD -23.37 g/m2, p=<0.001). Surgical aortic valve replacement was associated with a 16.9% reduction in left ventricular mass index at 1 year, with baseline mass index being the only independent predictor of this reverse remodeling.
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