Impact of Valvuloarterial Impedance on Left Ventricular Reverse Remodeling After Aortic Valve Neocuspidization

Overview

Journal J Cardiothorac Surg

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2022 Jan 30

PMID 35093156

Authors

Naoki Yamamoto

Hisato Ito

Kentaro Inoue

Ayano Futsuki

Koji Hirano

Yu Shomura

Yasuhisa Ozu

Yoshihiko Katayama

Takuya Komada

Motoshi Takao

Affiliations

Soon will be listed here.

Abstract

Background: Aortic valve neocuspidization (AVNeo) has emerged as a promising aortic valve procedure, and is expected to have a larger effective orifice area (EOA) than commercially available bioprostheses. It is, however, unclear which indices could facilitate left ventricular (LV) reverse remodeling after AVNeo. The aim of this study is to verify the impact of global left ventricular afterload on the LV reverse remodeling following AVNeo.

Methods: Data-available consecutive 38 patients (median age, 77; interquartile range, 72.8-82.0) undergoing AVNeo for severe aortic stenosis were enrolled in this study. Preoperative and the last follow-up echocardiographic data were retrospectively analyzed including the valvuloarterial impedance (Zva), a marker of global LV afterload. Reduction in LV geometry index (LVGI) and relative wall thickness (RWT) were used as an indicator for LV reverse remodeling.

Results: The Zva reduced in 24 patients (63.2%) during the follow-up period (median, 12 months). Reduction in Zva significantly correlated to improvement of LV geometry (LVGI (r = 0.400, p = 0.013) and RWT (r = 0.627, p < 0.001)), whereas increase in EOA index did not significantly correlate to LVGI (r = 0.009, p = 0.957), or RWT (r = 0.105, p = 0.529)). The reduction in Zva was the multivariate predictor of LV reverse remodeling.

Conclusions: Low global LV afterload led to significant LV reverse remodeling even after AVNeo, which could achieve better valve performance than the conventional bioprostheses.

Citing Articles

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Outcomes of Ozaki Procedure/Aortic Valve Neocuspidization for Aortic Valve Diseases: A Systematic Review.

Badalyan S, Markosyan S, Ismailbaev A, Asghar A, Rehman A Anatol J Cardiol. 2023; 27(11):619-627.

PMID: 37909351 PMC: 10621611. DOI: 10.14744/AnatolJCardiol.2023.3477.

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