ASSESSMENT OF RELATIONSHIP BETWEEN THE PATTERN OF HYPERTROPHY AND THE FUNCTION OF LEFT VENTRICLE IN PATIENTS WITH CHRONIC AORTIC REGURGITATION

概要

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Pre- and postoperative echocardiograms of 64 patients with chronic aortic regurgitation who had undergone isolated aortic valvular replacement (AVR) were studied. These patients were divided into 3 groups as follows: (1) Group A patients who had preoperative end-diastolic radius to wall thickness ratio (R/Thd) ⩽ 3. (2) Group B1 patients who had preoperative R/Thd>3 and end-systolic radius to wall thickness ratio (R/Ths)<2. (3) Group B2 patients who had preoperative R/Thd>3 and R/Ths ⩾ 2. Using this classification we assessed the relation between the pattern of hypertrophy and left ventricular (LV) function and the reversibility of LV dysfunction following AVR. Preoperatively, ejection fraction (EF) during handgrip exercise was unchanged in Group A (%ΔEF: -2.8 ± 7.1%) and significantly decreased in Groups B1 (-17.0 ± 5.8%) and B2 (-20.2 ± 4.6%). In the late postoperative period, however, it was, -1.2 ± 3.3%, -2.0 ± 4.6%, and -17.7 ± 8.6% in Groups A, B1, B2, respectively. Preoperatively the slope of end-systolic wall stress/volume (ESWS-ESV relation was 1.96 ± 0.43 in Group A (p<0.01 vs Group B2, NS vs Group B1), 1.54 ± 0.38 in Group B1 (NS vs Group B2) and 1.17 :± 0.47 in Group B2. It was stressed that a good relationship existed between the pattern of hypertrophy and function as well as the reversibility of LV dysfunction following AVR.
社団法人日本循環器学会の論文
1990-02-20