Advanced Search
| Home | Sitemap | Contact us
Original Article
Table of Contents
Abstract
PDF Links PDF Links
IMPACT OF SYSTEMIC ARTERIAL LOADING ON CONCENTRIC REMODELING IN AORTIC STENOSIS AND ITS REGRESSION AFTER VALVE REPLACEMENT
Jeong Yoon Jang2,1*, Jeong-Sook Seo3, Byung Joo Sun4, Dae-Hee Kim1, Jong-Min Song1, Duk-Hyun Kang1, Jae-Kwan Song1*
1Cardiac Imaging Center, Asan Medical Center Heart Institute, University of Ulsan College of Medicine
2Gyeongsang National University School of Medicine and Cardiovascular Center Department of Internal Medicine
3Inje University Busan Paik Hospital
4Chungnam National University Hospital
Corresponding Author: Jeong Yoon Jang ,Email: drjang80@naver.com
ABSTRACT
Background:
Left ventricle in patients with aortic stenosis (AS) faces a double hemodynamic load incorporating both valvular stenosis and reduced systemic arterial compliance (SAC). This study aimed to evaluate the impact of global LV afterload on LV hypertrophy (LVH) before and after aortic valve replacement (AVR). Methods and Resutls: The study cohort included 453 patients (247 males; mean age, 64±11 years) who underwent AVR. Pre- and post-AVR echocardiographic examinations were retrospectively analyzed including an index of valvular-arterial impedance (ZVA) and LV mass index/LV end-diastolic volume index (LVMI/LVEDVI) as a parameter of LVH. Pre-AVR LVMI/LVEDVI was 2.7±0.9 g/ml with an aortic valve area (AVA) of 0.6±0.2 cm². ZVA was 5.9±1.9 mmHg/ml/m² and showed a stronger correlation (β=0.601, p<0.001) with pre-AVR LVMI/LVEDVI than indexed AVA (β=0.061, p=0.19), Vmax (β=0.211, p<0.001). During a median follow-up of 2.4 years, patients had a 29.6±34.2% decrease in the LV geometry index with a decrease in SAC from 1.20±0.49 to 1.04±0.40 ml/m²/mmHg (p=0.002). Pre-AVR LV ejection fraction (r=0.262, p<0.001) and change in pressure gradient (r=0.155, p=0.001) and SAC (r=-0.222, p<0.001) were independent factors associated with LVH regression.
Conclusion:
ZVA and SAC are major determinants of concentric remodeling in AS and LVH regression after AVR. Progressive decrease in SAC can partly explain incomplete LVH regression after AVR, which suggests that SAC could be a potential therapeutic target.
Keywords: Aortic stenosis, Left ventricular hypertrophy, Afterload, Echocardiography
Volume 25, No 3
e-submission
JCU
KSE-JCU
Korean Society of Journal of Cardiovascular Ultrasound Office
1215 Hyundaihyel, 173 Mapo-daero, Mapo-gu, Seoul, 04130, Korea
TEL : +82-2-3147-0930   FAX:+82-2-3147-0933   E-mail: kse0930@ksecho.org
BrowseCurrent IssueFor Authors and ReviewersAbout
Copyright@2011 Korean Society of Journal of Cardiovascular Ultrasound Research. All right reserved.