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Postoperative Left Ventricular Mass Regression After Aortic Valve Replacement for Aortic Stenosis  Hiroshi Tomoeda, MD, Tomohiro Ueda, MD, Hideki Teshima,

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Presentation on theme: "Postoperative Left Ventricular Mass Regression After Aortic Valve Replacement for Aortic Stenosis  Hiroshi Tomoeda, MD, Tomohiro Ueda, MD, Hideki Teshima,"— Presentation transcript:

1 Postoperative Left Ventricular Mass Regression After Aortic Valve Replacement for Aortic Stenosis 
Hiroshi Tomoeda, MD, Tomohiro Ueda, MD, Hideki Teshima, MD, Koichi Arinaga, MD, Keiichiro Tayama, MD, Shuji Fukunaga, MD, Shigeaki Aoyagi, MD  The Annals of Thoracic Surgery  Volume 89, Issue 3, Pages (March 2010) DOI: /j.athoracsur Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Preliminary study for adjustment of catheter pressure and Doppler echo pressure study. The relation between CPG and the pPG is described by the next formula; CP = × pPG−2.25 (r2 = 0.68, p < 0.001). (CP = catheter pressure; pPG = peak pressure gradient measured by continuous-wave Doppler.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 The LV in systole was assumed to be a cone with a base diameter of Ds and a side wall radius of 1.85 Ds. (Ds = end-systolic diameter; LV = left ventricle.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Change in left ventricular mass index (LVMI). The LVMI significantly decreased within one year after operation, but no further regression was observed after that. (* = p < 0.01; ** = p < 0.05; Mp.o = months postoperative; Wp.o = weeks postoperative; Yp.o = years postoperative.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Correlation between the EOAI and LVMI six years after the operation. (Y = X; r = 0.045; r2 = 0.002, p = 0.80.) (EOAI = effective orifice area index; LVMI = left ventricular mass index.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Correlation between sum of the pressure “SysBP × pPG” and left ventricular mass (LVM) six years after the operation (Y = − X, r = 0.48, r2 = 0.23, p < 0.004). SysBP indicates the lowest of three blood pressure readings obtained using a sphygmomanometer and pPG is the peak pressure data across the prosthesis obtained using continuous-wave Doppler. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 When the patients were divided into two groups according to the sum of the pressure at the prosthetic valve orifice (H group: 150 mm Hg or more; L group: less than 150 mm Hg), the H group exhibited significantly higher left ventricular mass (LVM) compared with the L group. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

8 Fig 7 Correlation between the factor of “EOA × (SysBP × pPG)” and LVM six years after the operation (Y = − X, r = 0.58, r2 = 0.34, p < ). (EOA = effective orifice area; LVM = left ventricular mass; pPG = peak pressure gradient; SysBP = lowest value of the systolic pressure.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

9 Fig 8 Correlation between the new index and the left ventricular mass (LVM) six years after the operation. The results indicate a strong correlation between the new index and the LVM (Y = X, r = 0.82, r2 = 0.67, p < ) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

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