Abstract 2064: Left Ventricular Shape Predicts the Recovery of Left Ventricular Function after Isolated Aortic Valve Replacement for Aortic Valve Stenosis
Background: Improvement in left ventricular (LV) systolic function after aortic valve replacement (AVR) has been observed in patients with aortic valve stenosis (AS). However, the factors which predict such recovery remain unclear.
Methods: This study consisted of 101 patients (aged 70±11 years) with critical to severe AS (aortic valve area <1.1cm2) and LV systolic dysfunction (ejection fraction; EF <50%) who had echocardiography before and after (9 ±14 days) AVR. Patients with poor echocardiographic image quality, significant aortic or mitral regurgitation (grade >2+), congenital heart disease and other cardiac surgery such as coronary artery bypass graft were excluded. LV end-diastolic and end-systolic volumes indexes (EDVI and ESVI, respectively), and EF were measured by the Simpson method. LV mass index was calculated by area-length method (LVMI). LV end-diastolic and end-systolic sphericity were calculated as the ratio of the minor width to the major axis length of LV in apical 4-chamber view (EDSP and ESSP, respectively).
Results: The postoperative EF was associated with preoperative EF, EDVI, ESVI, LVMI, EDSP, and ESSP (all P<0.001) (Figure⇓). Multivariate analysis revealed that preoperative EF, ESVI, and EDSP were independent parameters predicting postoperative EF (all P<0.001). The sensitivity and specificity in predicting normalization of LV systolic function (EF >50%) after AVR were 84% and 63% for EDSP <0.565 and 91% and 65% for ESSP <0.465, respectively.
Conclusions: Non-spherical LV shape and smaller LV volume predict the recovery of LV function in AS patients after isolated AVR. This may suggest earlier surgery in AS patients showing increased sphericity.