2026-03-09T14:41:30Z https://mie-u.repo.nii.ac.jp/oai

oai:mie-u.repo.nii.ac.jp:00015232 2023-10-17T01:53:59Z 334:608:618:1336

Impact of valvuloarterial impedance on left ventricular reverse remodeling after aortic valve neocuspidization Yamamoto, Naoki ヤマモト, ナオキ 山本, 直樹 open access Aortic valve neocuspidization Aortic valve stenosis Left ventricular geometry Left ventricular reverse remodeling Valvuloarterial impedance application/pdf Background: Aortic valve neocuspidization (AVNeo) has emerged as a promising aortic valve procedure, and is expected to have a larger effective orifice area (EOA) than commercially available bioprostheses. It is, however, unclear which indices could facilitate left ventricular (LV) reverse remodeling after AVNeo. The aim of this study is to verify the impact of global left ventricular afterload on the LV reverse remodeling following AVNeo.Methods: Data-available consecutive 38 patients (median age, 77; interquartile range, 72.8–82.0) undergoing AVNeo for severe aortic stenosis were enrolled in this study. Preoperative and the last follow-up echocardiographic data were retrospectively analyzed including the valvuloarterial impedance (Zva), a marker of global LV afterload. Reduction in LV geometry index (LVGI) and relative wall thickness (RWT) were used as an indicator for LV reverse remodeling. Results: The Zva reduced in 24 patients (63.2%) during the follow-up period (median, 12 months). Reduction in Zva significantly correlated to improvement of LV geometry (LVGI (r = 0.400, p = 0.013) and RWT (r = 0.627, p < 0.001)),whereas increase in EOA index did not significantly correlate to LVGI (r = 0.009, p = 0.957), or RWT (r = 0.105, p = 0.529)). The reduction in Zva was the multivariate predictor of LV reverse remodeling. Conclusions: Low global LV afterload led to significant LV reverse remodeling even after AVNeo, which could achieve better valve performance than the conventional bioprostheses. 本文/Department of Thoracic and Cardiovascular Surgery, Mie University Hospital, 2‑174 Edobashi, Tsu City, Mie 514‑8507, Japan 9p 三重大学 2022-07-20 eng doctoral thesis VoR http://hdl.handle.net/10076/00020850 https://mie-u.repo.nii.ac.jp/records/15232 10.1186/s13019-022-01760-7 甲医学第2144号 博士(医学) 2022-07-20 14101 三重大学 https://mie-u.repo.nii.ac.jp/record/15232/files/2022DM0718.pdf application/pdf 1.3 MB 2022-10-24