Smanjenje mase lijeve klijetke i globalne longitudinalne deformacije u bolesnika s teškom aortnom stenozom tri mjeseca nakon zamjene aortne valvule.

Objectives: Aortic stenosis is accompanied by progressive left ventricular hypertrophy and fibrosis.1 This study sought to investigate the intensity of potential reversal changes in left ventricular (LV) mass and global longitudinal strain at 3 months follow up after aortic valve replacement surgery. Patients and Methods: A total of 47 patients (age 70.32 ± 7.59 years; 53,2% female) with severe, symptomatic AS were assessed pre-aortic valve replacement (AVR) by echocardiography. Bioprostheses were implanted in 41 patients (87.23 %), and the 6 remaining patients (12.77 %) received mechanical prostheses. Assessment was repeated at three months post-AVR. Results: At three months post-operatively the mean valve gradient had improved (52.05±13.38 mmHg to 13.05±4.36 mm Hg; p<0.001), and indexed LV mass had regressed by 10.85 % (180.91±43.96 g/m2 t o 1 69.18±38.15 g /m2; p<0.001). However, at three months post-AVR, these changes were not accompanied by reduction in LV end-diastolic volume index (57.74±16.78 ml/m2 to 61.45±17.34 ml/m2) and LV endsystolic volume index (25.42±11.09 ml/m2 to 27.05± 12.25ml/ m2; P=0.294). Also, left ventricular ejection fraction (LVEF) did not improve (P=0.66). Nevertheless, septal thickness (P<0.001), posterior (PWT) wall thickness (P=0.001), and relative (RWT) wall thickness (P=0.032) were significantly reduced at follow-up. In addition, average global longitudinal strain (GLS; -15.86±4.25 to -17.16±3.42; P=0.008) and strain measured in two chamber view (2ch; -15.13±5.19 to -16.66±3.87; P=0.013) were also significantly improved while the strain measured in PLAX (-16.83±4.92 to -17.92±4.12; P=0.128) and in four-chamber view (4ch; -15.48±4.64 to -19.06±16.72; P=0.128) showed statistically insignificant improvement at 3 months follow up. There was no statistically significant improvement in diastolic function of LV. Conclusions: Three months post-AVR patients showed significant improvement in LV systolic function measured by GLS but not LVEF as well as improvement in reverse remodeling depicted by regression in LV mass. We did not see improvement in LV diastolic function. [ABSTRACT FROM AUTHOR]