This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wisenbaugh, T. Articles by Waters, J. Search for Related Content PubMed PubMed Citation Articles by Wisenbaugh, T. Articles by Waters, J.

Circulation, Vol 73, 47-53, Copyright © 1986 by American Heart Association

ARTICLES

Relationship of contractile state to ejection performance in patients with chronic aortic valve disease

T Wisenbaugh, D Booth, A DeMaria, S Nissen and J Waters

To assess the relative contributions of afterload mismatch and impaired contractility to pump dysfunction in patients with chronic aortic valve disease, simultaneous left ventricular cineangiography and micromanometry were performed in 56 patients: 21 with severe aortic stenosis, 16 with severe aortic regurgitation, and 19 normal control subjects. Left ventricular mass was increased in patients with aortic stenosis and aortic regurgitation (172 +/- 52 and 224 +/- 63 g/m2, respectively, vs 89 +/- 16 for control subjects; p less than .05) as were end-diastolic volume (101 +/- 39 and 167 +/- 44 vs 77 +/- 16 ml/m2; p less than .05) and end-systolic volume (50 +/- 40 and 84 +/- 43 vs 24 +/- 7 ml/m2; p less than .05). Although ejection fraction was depressed in both abnormal groups (0.56 +/- 0.18 for patients with aortic stenosis and 0.53 +/- 0.13 for those with aortic regurgitation vs 0.69 +/- 0.05 for control subjects; p less than .05), the decrease in ejection fraction was disproportionate to the mild degree of afterload mismatch (end ejection stress 129 +/- 17 in patients with aortic stenosis and 154 +/- 58 in those with aortic regurgitation vs 117 +/- 46 kdyn/cm2 in control subjects; p = NS) with 10 of 21 patients with aortic stenosis and 12 of 16 patients with aortic regurgitation falling below the 95% prediction limit of the linear inverse relationship between ejection fraction and end-systolic stress for controls (EF = 0.78 - 0.00074 X ESS).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				K. Taniguchi, T. Takahashi, K. Toda, H. Matsue, Y. Shudo, H. Shintani, M. Mitsuno, and Y. Sawa Left ventricular mass: impact on left ventricular contractile function and its reversibility in patients undergoing aortic valve replacement Eur. J. Cardiothorac. Surg., October 1, 2007; 32(4): 588 - 595. [Abstract] [Full Text] [PDF]

				R. G. Fuster, J. A. M. Argudo, O. G. Albarova, F. H. Sos, S. C. Lopez, M. J. D. Sorli, M. B. Codoner, and J. A. B. Minano Left ventricular mass index in aortic valve surgery: a new index for early valve replacement? Eur. J. Cardiothorac. Surg., May 1, 2003; 23(5): 696 - 702. [Abstract] [Full Text] [PDF]

				R. H. Mehta, D. Bruckman, S. Das, T. Tsai, P. Russman, D. Karavite, H. Monaghan, S. Sonnad, M. J. Shea, K. A. Eagle, et al. Implications of increased left ventricular mass index on in-hospital outcomes in patients undergoing aortic valve surgery J. Thorac. Cardiovasc. Surg., November 1, 2001; 122(5): 919 - 928. [Abstract] [Full Text] [PDF]

				D. E. Powell, P. A. Tunick, B. P. Rosenzweig, R. S. Freedberg, E. S. Katz, R. M. Applebaum, J. L. Perez, and I. Kronzon Aortic Valve Replacement in Patients With Aortic Stenosis and Severe Left Ventricular Dysfunction Arch Intern Med, May 8, 2000; 160(9): 1337 - 1341. [Abstract] [Full Text] [PDF]

				J. S. Borer, C. Hochreiter, E. McM. Herrold, P. Supino, M. Aschermann, D. Wencker, R. B. Devereux, M. J. Roman, M. Szulc, P. Kligfield, et al. Prediction of Indications for Valve Replacement Among Asymptomatic or Minimally Symptomatic Patients With Chronic Aortic Regurgitation and Normal Left Ventricular Performance Circulation, February 17, 1998; 97(6): 525 - 534. [Abstract] [Full Text] [PDF]