Document Detail


Longitudinal study of the profile and predictors of left ventricular mass regression after stentless aortic valve replacement.
MedLine Citation:
PMID:  18498814     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to evaluate the long-term profile and determine the factors that would influence the effect and rate of ventricular mass regression with time after aortic valve replacement with a stentless or a homograft valve.
METHODS: We studied 300 patients during a 10-year period with at least a year of follow-up with a total of 1,273 serial echocardiographic measurements. Left ventricular mass was calculated from M-mode recordings and indexed to body surface area. Longitudinal data analysis was performed using a linear mixed effects model.
RESULTS: The mean age (+/- standard deviation) was 65 (+/-14) years, consisting of 216 (72%) males. A stentless valve was implanted in 156 (52%), and a homograft in 144 (48%). The median time (interquartile range) to follow-up was 4.7 (2.8 to 6.6) years. The greatest rate of left ventricular mass regression occurred in the first year after surgery. On multivariable modeling, independent predictors of left ventricular mass were valve size (p = 0.011), left ventricular function (moderate impairment, p = 0.418; severe impairment, p = 0.011), and baseline left ventricular mass (middle tercile, p < 0.001; highest tercile, p < 0.001). Only baseline ventricular mass influenced the rate of subsequent left ventricular mass regression; the greatest rate of regression occurred in patients with the highest baseline values of ventricular mass (p < 0.001).
CONCLUSIONS: The greatest rate of left ventricular mass regression occurs in the first year with baseline left ventricular mass as the strongest predictor and the only identified variable that influenced the rate of left ventricular mass regression.
Authors:
Eric Lim; Ayyaz Ali; Panagiotis Theodorou; Ines Sousa; Hutan Ashrafian; Themis Chamageorgakis; Alison Duncan; Michael Henein; Peter Diggle; John Pepper
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  85     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-23     Completed Date:  2008-06-12     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  2026-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Valve Insufficiency / surgery*,  ultrasonography
Aortic Valve Stenosis / surgery*,  ultrasonography
Bioprosthesis*
Echocardiography
Female
Heart Valve Prosthesis*
Heart Valves / transplantation*
Humans
Hypertrophy, Left Ventricular / surgery*,  ultrasonography
Longitudinal Studies
Male
Middle Aged
Prosthesis Design
Reoperation
Transplantation, Homologous
Grant Support
ID/Acronym/Agency:
G0400615//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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