Effects of valve replacement on ventricular mechanics in mitral regurgitation and aortic stenosis.
Published
Journal Article
BACKGROUND: This study in humans assessed changes in left ventricular function early and late after correction of mitral regurgitation (MR) (n = 9) or aortic stenosis (AS) (n = 10). METHODS: Ventricular function was measured with radionuclide and micromanometer-derived pressure-volume loops during preload manipulation, thermodilution cardiac outputs, and echocardiograms. Late radionuclide and echocardiographic data were acquired at 24 hours and 20 months. RESULTS: Perioperative left ventricular performance (stroke work-end-diastolic volume relationship) did not change for patients with MR or AS. Significant changes in afterload occurred: ejection fraction (MR, 0.49 to 0.37; AS, 0.54 to 0.60; both, p = 0.013), mean left ventricular ejection pressure (MR, 73 to 91 mm Hg; AS, 138 to 93 mm Hg; both, p < 0.01), and end-systolic wall stress (MR, 26 to 42 x 10(3) dynes/cm2; AS, 37 to 22 x 10(3) dynes/cm2; both, p < 0.01). Ejection efficiency improved for MR patients (0.69 +/- 0.26 to 1.0 +/- 0.15; p < 0.05). The 20-month data showed improved New York Heart Association functional class, normal resting ejection fraction, and normal exercise response for both groups. CONCLUSIONS: Early after operation, a significant change in left ventricular load was seen with correction of MR and AS. Data obtained late after operation showed improvement consistent with ventricular remodeling.
Full Text
Duke Authors
Cited Authors
- Harpole, DH; Gall, SA; Wolfe, WG; Rankin, JS; Jones, RH
Published Date
- September 1996
Published In
Volume / Issue
- 62 / 3
Start / End Page
- 756 - 761
PubMed ID
- 8784004
Pubmed Central ID
- 8784004
International Standard Serial Number (ISSN)
- 0003-4975
Digital Object Identifier (DOI)
- 10.1016/s0003-4975(96)00378-5
Language
- eng
Conference Location
- Netherlands