Haris Munirwan1,2, Amiliana Mardiani Soesanto1,3, Rarsari Soerarso1, A. H. Arinto Bono11Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/National Cardiovascular Center, Harapan Kita, Jakarta, Indonesia
2Universitas Syiah Kuala, Banda Aceh, Indonesia
3Electronic correspondence: firstname.lastname@example.org
Background and aim of the study: Left ventricle reverse remodeling (LVRR) is an important predictor for good outcome after aortic valve surgery in chronic aortic regurgitation (AR). Previous studies have identified different factors as predictors for LVRR, with non-rheumatic heart disease as a common etiology of AR. The study aim was to identify factors associated with early LVRR after aortic valve surgery in chronic AR, with rheumatic valve disease as a predominant etiology.
Methods: A total of 130 patients aged >18 years with chronic AR and who underwent single aortic valve replacement (AVR) at the authors’ institution between January 2007 and December 2017, was studied retrospectively. Patients were allocated to two groups: group 1 (n = 70) included patients with early LVRR, while group 2 (n = 60) included patients without LVRR. Early reverse remodeling was defined as a preoperative left
ventricular end-diastolic diameter reduction >20% during a seven- to 30-day postoperative evaluation. Bivariate and multivariate analyses were performed to evaluate the correlation between clinical data and LVRR.
Results: Early LVRR was seen in 53.8% of all patients. Rheumatic heart disease as etiology of AR was present in 62 patients (47.7%). The preoperative left ventricular ejection fraction (LVEF) was the only independent variable that correlated with LVRR. Preoperative LVEF with cut-off >56.5% was associated with LVRR after surgery (p = 0.01; OR 2.42), with a sensitivity of 61%, a specificity of 60%, and area under the curve of 0.683 (p <0.001).
Conclusion: The preoperative LVEF was independently correlated with early LVRR after aortic valve surgery in chronic AR.
The Journal of Heart Valve Disease 2018-19;27:306-313
|Factors Associated with Early Left Ventricle Reverse Remodeling after Aortic Valve Surgery in Chronic Aortic Regurgitation|
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