Vol 18, No 3 (2011)
Original articles
Published online: 2011-06-09

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Impact of moderate coronary atherosclerosis on long-term left ventricular remodeling after aortic valve replacement

Jose Antonio Linares Vicente, Isaac Lacambra Blasco, Pilar Portero Perez, Borja Simo Sanchez, Maria Rosario Ortas Nadal, Jose Ramón Ruiz Arroyo, Mariano González Carretero, Alfonso Del Rio Ligorit
Cardiol J 2011;18(3):277-281.

Abstract

Background: The role of coronary atherosclerosis (CA+) in ventricular remodeling after aortic valve replacement (AVR) for isolated aortic stenosis (AS) is not well defined. We sought to evaluate the impact of not revascularized moderate coronary atherosclerosis in long-term left ventricular (LV) remodeling after AVR.
Methods: We assessed by coronariography the coronary artery disease in 66 patients referred for AVR and evaluated morphological and functional LV data by echocardiography both preoperatively and postoperatively (3 ± 1.2 years).
Results: In patients without coronary atherosclerosis, hypertrophy regression was more intense and the absolute reverse remodeling was higher in LV mass index (–55.8 ± 36 g/m2 vs –28.4 ± 34 g/m2, p = 0.004), reduction of LV dimensions (LV end-diastolic diameter [LVEDD]: –4.1 ± 7.4 mm vs –2.2 ± 8.3 mm, p = 0.04), and regression of wall thickness (interventricular septum [IVS]: –3.3 ± 2.6 mm vs –1.6 ± 2.2 mm, p = 0.01; and posterior wall thickness [PWT]: –2.1 ± 2.1 mm vs 0.6 ± 2.1 mm, p = 0.012).
Conclusions: After AVR for AS, not revascularized moderate coronary atherosclerosis determines a long-term lesser degree of LV hypertrophy regression and a worse absolute reverse remodeling of LV mass index, LVEDD, IVS and PWT. (Cardiol J 2011; 18, 3: 277–281)

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