Naseem Ahmad, Ahmad Shahbaz, Abdul Ghaffar, Zafar Tufail, Abdul Waheed, Jawad Sajid Khan


Background: Aortic valve disease is associated with eccentric or concentric left ventricular (LV)
hypertrophy and changes in the LV mass. The relationship between LV mass and function and the
effect of LV remodeling after aortic valve replacement (AVR), in patients with aortic valve
disease needs evaluation, that is largely unknown in our population. The aim of this study was to
evaluate the effect of AVR on LV remodeling, in patients with aortic valve disease. Methods:
Fifty patients with aortic valve disease were studied using transthoracic echocardiography to
assess LV mass before AVR and compared with early postoperative changes in the LV
dimensions and function. LV mass was studied preoperatively and before discharge in 50
consecutive patients undergoing isolated aortic valve replacement. Results: Out of fifty patients,
47(94%) were male and 03(6%) were female. Mean age of the patients was 40.42 years. 22 (44%)
had isolated aortic stenosis (AS), 16 (32%) patients had isolated aortic regurgitation (AR) and 12
(24%) patients had mixed aortic valve disease (MAVD). 02 (4%) patients died. LV mass
regression was studied in all the patients. In group A, with aortic stenosis, LV regressed to 69.88
gm (mean) with maximum of 156.88 gms and minimum of 0.00 gms (SD 43.67 gms, p value =
0.001). In group B, with aortic regurgitation, LV mass regressed to 203.96 gms (mean) with
maximum 453.79 gms and minimum of 45.65 gms (SD 95.33, p value = <0.001). In group C, with
mixed aortic valve disease, postoperatively LV mass regressed to 122.94 gms (mean) with
minimum 9.57 and maximum of 224.75 gms (SD 69.53, p value = 0.524). Conclusion: There was
significant early LV mass regression after aortic valve replacement in patients with pre existing
aortic valve disease. However, it was noticed that LV mass regressed in all patients except no
significant changes in LV wall thickness (hypertrophy).
Keywords: Aortic valve replacements; Left ventricular mass regression; Left ventricular function.

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Natsuaki M, Itoh T, Okazaki Y, Ishida H, Hamada M,

Rikitake K et al. Evaluation of postope rative cardiac

function and long-term results in patients after aortic valve

replacement for aortic valve d isease with increas ed left

ventricular mass. Jpn J Thorac Cardiovasc Surg 2000;


Bilal MBY, Rafi HBB, Sultan J, Shafi BBB, Abbasi SA,

Hussain A et al. 12 year’s experience of A ortic Valve

Replacement for Aortic Regurgitation. Pak J Cardiol 2004;


Lund O, Erlandsen M, Dørup I, Emmertsen K, Flø C, Jensen

FT. Predictable changes in left ventricular mass and function

during ten years after valve replacement for aortic stenosis. J

Heart Valve Dis. 2004; 13(3):357-68.

Sharma UC, Barenbrug P, Pokharel S, Dassen WR, Pinto

YM, Maessen JG. Systematic review of the outcome of aortic

valve replacement in patients with aortic stenosis. Ann

Thorac Surg 2004; 78(1):90-5.

Lamb HJ, Beyerbacht HP, de Roos A, van der Laarse A,

Vliegen HW, Leujes F et al. Left ventricular remodeling

early after aortic valve repla cement: differential effects on

diastolic function in aortic valve s tenosis and aortic

regurgitation. J Am Coll Cardiol 2002;40(12):2182-8.

Ikonomidis I, Tsoukas A, Parthenakis F, Gournizakis A,

Kassimatis A, Rallidis L et al. Four year follow up of aortic

valve replacement for isolated aortic stenosis: a link between

reduction in pressure overload, regression of left ventricular

hypertrophy, and diastolic function Heart 2001; 86:309-16.

Lund O, Erlandsen M. Changes in left ventricular function

and mass during serial investigations after valve replacement

for aortic stenosis. J Heart Valve Dis 2000; 9:583-93.

Imanaka K, Kohmoto O, Nishimura S, Yokote Y, Kyo S.

Impact of postoperative blood pressure control on regression

of left ventricular mass follo wing valve replacement for

aortic stenosis. Eur J Cardiothorac Surg 2005; 27(6):994-9.

Hafizullah M, Rehman A, Hassan MU, Taqweem A.

Optimal time for operation in Aortic Regurgitation. J

Postgrad Med Inst 2002:16(2):178-82

Karpuz H, Koldas L, Ayan F, Hacioglu Y. Short -Term

Regression of Left Ventricular Mass After Aortic Valve

Replacement in Aortic Stenosis With Left Ventricular

Concentric Hypertrophy. J Clin Basic Cardiol 2002; 5: 101.

Monrad ES, Hess OM, Murakami T , Nonogi H, Corin WJ,

Krayenbuehl HP. Time course of re gression of left

ventricular hypertrophy after aortic valve replacement.

Circulation 1988; 77(6):1345–55

Venco A, St John Sutton MG, Gibson DG, Brown DJ. Noninvasive assessment of left ve ntricular function after

correction of severe aortic regurg itation. Br Heart J 1976;


Collinson J, Flather M, Pepper JR, Henein M. Effects of

valve replacement on left ventricular function in patients with

aortic regurgitation and sever e ventricular disease. J Heart

Valve Dis 2004; 13(5):722-8.

Rao L, Mohr-Kahaly S, Geil S, Dahm M, Meyer J. Left

ventricular remodeling after a ortic valve replacement. Z

Kardiol 1999;88(4):283-9.

Ghali JK, Liao Y, Simmons B, C astaner A, Cao G, Cooper

RS. The prognostic role of lef t ventricular hypertrophy in

patients with or without coronary artery disease. Ann Intern

Med 1992;117(10):831–6.

He GW, Grunkemeier GL, Gately HL, Furnary AP, Starr A.

Up to thirty-year survival after aortic valve replacement in

the small aortic root. Ann Thorac Surg 1995;59(5):1056–62

Kurnik PB, Innerfield M, Wachs press JD, Eldredge WJ,

Waxman HL. Left ven tricular mass regression after aortic

valve replacement measured by ultrafast compute d

tomography. Am Heart J 1990;120(4):919–27

Henry WL, Bonow RO, Borer JS, Kent KM, Ware JH,

Redwood DR et al. Evaluation of aortic valve replacement in

patients with valvular aortic stenosis. Circulation 1980;



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