The effect of postoperative medical treatment on left ventricular mass regression after aortic valve replacement.
Publication/Presentation Date
3-1-2015
Abstract
OBJECTIVE: The study objective was to analyze factors associated with left ventricular mass regression in patients undergoing aortic valve replacement with a newer bioprosthesis, the Trifecta valve pericardial bioprosthesis (St Jude Medical Inc, St Paul, Minn).
METHODS: A total of 444 patients underwent aortic valve replacement with the Trifecta bioprosthesis from 2007 to 2009 at 6 US institutions. The clinical and echocardiographic data of 200 of these patients who had left ventricular hypertrophy and follow-up studies 1 year postoperatively were reviewed and compared to analyze factors affecting left ventricular mass regression.
RESULTS: Mean (standard deviation) age of the 200 study patients was 73 (9) years, 66% were men, and 92% had pure or predominant aortic valve stenosis. Complete left ventricular mass regression was observed in 102 patients (51%) by 1 year postoperatively. In univariate analysis, male sex, implantation of larger valves, larger left ventricular end-diastolic volume, and beta-blocker or calcium-channel blocker treatment at dismissal were significantly associated with complete mass regression. In the multivariate model, odds ratios (95% confidence intervals) indicated that male sex (3.38 [1.39-8.26]) and beta-blocker or calcium-channel blocker treatment at dismissal (3.41 [1.40-8.34]) were associated with increased probability of complete left ventricular mass regression. Patients with higher preoperative systolic blood pressure were less likely to have complete left ventricular mass regression (0.98 [0.97-0.99]).
CONCLUSIONS: Among patients with left ventricular hypertrophy, postoperative treatment with beta-blockers or calcium-channel blockers may enhance mass regression. This highlights the need for close medical follow-up after operation. Labeled valve size was not predictive of left ventricular mass regression.
Volume
149
Issue
3
First Page
781
Last Page
786
ISSN
1097-685X
Published In/Presented At
Helder, M. R., Ugur, M., Bavaria, J. E., Kshettry, V. R., Groh, M. A., Petracek, M. R., Jones, K. W., Suri, R. M., & Schaff, H. V. (2015). The effect of postoperative medical treatment on left ventricular mass regression after aortic valve replacement. The Journal of thoracic and cardiovascular surgery, 149(3), 781–786. https://doi.org/10.1016/j.jtcvs.2014.10.034
Disciplines
Medicine and Health Sciences
PubMedID
25433642
Department(s)
Department of Surgery
Document Type
Article