Key result
Surgical aortic valve replacement linked to ~38% reduction in LVMI at six months.
Why the study?
This study aimed to characterize and assess early left ventricular remodeling and its prognostic impact in patients with severe aortic valve stenosis and/or moderate-to-severe aortic regurgitation after aortic valve replacement.
Does surgical aortic valve replacement improve early left ventricular remodeling in patients with severe aortic valve disease?
Observational (n=82)
No
Does surgical aortic valve replacement improve early left ventricular remodeling in patients with severe aortic valve disease?
p-value: p=< 0.001
Surgical aortic valve replacement leads to significant early reverse myocardial remodeling and reduction in left ventricular mass index as early as 1 week postoperatively.
SAVR was associated with marked LVMI reduction at 6 months; leaves open outcome benefits and generalizability beyond this cohort.
BACKGROUND: Aortic valve disease leads to eccentric or concentric left ventricular (LV) hypertrophy and changes in the LV function, which results from cellular (hypertrophy) and extracellular matrix expansion (interstitial fibrosis). The goal of aortic valve replacement (AVR) is to alleviate the pressure and volume overload on the LV, allowing myocardial remodelling and regression of LV mass. OBJECTIVES: This study aims to characterize and assess early LV remodelling in patients with severe aortic valve stenosis and/or moderate-to-severe aortic regurgitation after AVR and assess its prognostic impact. MATERIALS AND METHODS: This prospective study of 82 patients with aortic valve disease was conducted in the department of cardiovascular and thoracic surgery between October 2023 and October 2025. All patients undergoing AVR exclusively over 2 years 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 the aortic valve, LV ejection fraction, fractional shortening, LV dimensions, and LV mass, along with other hemodynamic parameters, were measured in the pre- and postoperative period. RESULTS: A total of 82 patients with different aortic valve lesions who underwent AVR were evaluated. All but one child (aged 14 years) were adults with a median age of 54 years ± 15.6 years, including 64 males and 18 females. The LV mass index (LVMI) regression occurred over time in all patients who underwent AVR. Mean LVMI decreased to 148.2 ± 54.7 g/m 2 at 1 week, 122.8 ± 44.4 g/m 2 at 6 weeks, 116.4 ± 38.6 g/m 2 at 3 months, and 110.9 g/m 2 at 6 months of AVR from its baseline value of 178.8 ± 56.9 g/m 2 ( P < 0.001). LV end-diastolic dimension improved significantly ( P < 0.001) from preoperative mean value of 52.24 ± 12.17 mm to 42.23 ± 12.25 mm at 1 week, 38.66 ± 12.9 mm at 6 weeks, 36.16 ± 7.24 at 3 months, and 35.17 ± 8.70 at 6 months. Reduction continued significantly up to 6 months in respect to values at 1 week. CONCLUSION: Marked reduction in LV mass and reverse myocardial remodeling was observed 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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Rahul et al. (2026) conducted an observational in Aortic valve disease (n=82). Surgical aortic valve replacement vs. Baseline (preoperative) was evaluated on Left ventricular mass index (LVMI) (p=< 0.001). Surgical aortic valve replacement significantly reduced mean left ventricular mass index from 178.8 g/m2 at baseline to 110.9 g/m2 at 6 months (P<0.001).
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