Abstract 20675: Utility of End-Systolic Ventricular Elastance for Predicting Post-Operative Left Ventricular Dysfunction in Patients With Severe Aortic Regurgitation and Preserved Left Ventricular Ejection Fraction
Background: Patients with chronic aortic regurgitation (AR) suffer from volume and pressure overload. Post-operative left ventricular (LV) systolic function is an important determinant of post-operative prognosis, but its detection is rather difficult. Although the LV ejection fraction (LVEF) is the most widely used measurement of LV function upon which surgical risk assessment is based, it is reduced only in patients with end-stage AR. On the other hand, end-systolic ventricular elastance (Ees), the slope of the end-systolic pressure-volume relationship, is thought to be a load-independent index of myocardial contractility. The purpose of this study was to investigate the utility of Ees for detecting postoperative LV dysfunction in chronic severe AR patients with preserved LVEF.
Method: We studied 33 chronic severe AR patients undergoing surgical correction with preserved LVEF of 60±5% (all >50%). On the basis of previous studies by Chen et al, Ees was estimated by using the non-invasive single-beat technique determined from blood pressure, stroke volume, pre-ejection and total systolic periods, LVEF, and an estimated normalized ventricular elastance at arterial end-diastole. Patients with a post-operative LVEF<50% were considered to have impaired LV systolic function.
Result: Thirteen (39%) patients were development of post-operative LV dysfunction, and the remaining 20 were classified as preserved LVEF after surgical correction. An important finding of the multivariate logistic regression analysis was that Ees was the most powerful predictor of post-operative LV dysfunction (p=0.029). In addition, the relative change in LVEF after surgical correction was significantly correlated with Ees before surgical correction (r=0.44, p<0.01).
Conclusion: Ees was excellent predictor of post-operative LV dysfunction in chronic severe AR patients with preserved LVEF, and may well have clinical implications for better management of such patients.
Author Disclosures: J. Ooka: None. H. Tanaka: None. K. Matsumoto: None. H. Takada: None. F. Soga: None. Y. Hatani: None. K. Hatazawa: None. H. Matsuzoe: None. H. Shimoura: None. H. Sano: None. Y. Mochizuki: None. K. Ryo-Koriyama: None. K. Hirata: None.
- © 2016 by American Heart Association, Inc.