Authors

• Ivana Jurin — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0002-2637-9691
• Josip Varvodić — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0001-6602-699X
• Dubravka Šušnjar — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0002-9644-9739
• Irzal Hadžibegović — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0001-9139-5009
• Tomo Svaguša — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0002-2036-1239
• Tomislav Letilović — Klinička bolnica Merkur, Zagreb, Hrvatska — ORCID: 0000-0003-1229-7983
• Stipe Radoš — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0003-2183-3506
• Nino Tičinović — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0001-6613-9492
• Jasenka Grgurić — Medicinski fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska — ORCID: 0000-0002-0876-6217
• Frane Paić — Medicinski fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska — ORCID: 0000-0001-9688-8582
• Igor Rudež — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0002-7735-6721

Abstract

**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; p2 to 169.18±38.15 g/m2; p2 to 61.45±17.34 ml/m2) and LV end-systolic 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.

Keywords

aortic stenosis, aortic valve replacement, left ventricular mass index, global longitudinal strain

DOI

Literature

1. Vizzardi E, Sciatti E, Bonadei I, Rovetta R, D’Aloia A, Gelsomino S, et al. Effects of transcatheter aortic valve implantation on left ventricular mass and global longitudinal strain: tissue Doppler and strain evaluation. Heart Lung Vessel. 2014;6(4):253–61. https://pubmed.ncbi.nlm.nih.gov/25436207/