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Eur J Cardiothorac Surg 2003;24:667
© 2003 Elsevier Science NL

Letter to the Editor

Left ventricular mass index in aortic valve surgery: a new index for early valve replacement?

Division of Cardiovascular Surgery, Jichi Medical School, 3311-1 Yakushiji, Minami-kawachi, Tochigi 329-0498, Japan

Received 23 June 2003; accepted 15 July 2003.

^* Tel.: +81-285-587368; fax: +81-285-446271
e-mail: tcvmisa{at}jichi.ac.jp

Key Words: Aortic valve replacement • Aortic valve regurgitation • Left ventricular mass index • Left ventricular remodeling

With great interest, I read a paper by Fuster and colleagues in this Journal's May 2003 issue [1]. They detailed the use of echocardiographic left ventricular dimensions to calculate a left ventricular mass index in 614 patients, and analyzed the effect of increased left ventricular mass index on outcomes in patients undergoing aortic valve replacement. They concluded that increased left ventricular mass index was associated with an in-hospital adverse outcome with higher in-hospital mortality in the patients.

We have reported our clinical experience with 25 consecutive patients undergoing aortic valve replacement because of isolated aortic valve regurgitation (AR). All the patients survived through follow-ups of a mean 55±30 months after operation. We analyzed relations between preoperative left ventricular dimensions and postoperative left ventricular remodeling by serial echocardiographic assessment; concluding that in order to normalize the left ventricular function in isolated AR patients, those patients who had left ventricular end-systolic dimension (LVD) greater than 50 mm and fractional shortening (FS) less than 25% required 3 years after operation, while those who had LVDs less than or equal to 50 mm and/or FS greater than or equal to 25% required only 1 year after operation [2].

Left ventricular mass index depends on left ventricular dimensions and wall thickness. As mentioned above, Fuster and colleagues have shown the higher mortality in the patients with increased left ventricular mass index, and we have shown the delayed hemodynamic recovery in patients with dilated left ventricles. These studies indicate that operative procedures should be recommended in aortic valve disease patients prior to excessive ventricular remodeling.

References

1. Fuster R.G., Argudo J.A., Albarova O.G., Sos F.H., Lopez S.C., Sorli; M.J., Codoner M.B., Minano J.A. Left ventricular mass index in aortic valve surgery: a new index for early valve replacement?. Eur J Cardiothorac Surg 2003;23:696-702.[Abstract/Free Full Text]
2. Misawa Y., Hasegawa T., Kato M., Horimi H., Yamaguchi T. Serial assessment of left ventricular function after valve replacement for isolated aortic regurgitation. Nippon Kyobu Geka Gakkai Zasshi 1991;39:388-392.[Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Yoshio Misawa Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Misawa, Y. Search for Related Content PubMed PubMed Citation Articles by Misawa, Y. Related Collections Cardiac - physiology Valve disease