Aortic Regurgitation Clinical Trial
Official title:
Persistent Diastolic Dysfunction Late After Valve Replacement in Severe Aortic Regurgitation
Follow-up study in patients with severe aortic regurgitation after successful valve replacement. Systolic and diastolic function were assessed and persistent diastolic dysfunction was observed late (7-10 years) after operation.
Background
Patients with severe aortic regurgitation show eccentric LV hypertrophy and structural
changes of the myocardium. Reversibility of functional and structural changes after
successful valve replacement may be limited. Persistent diastolic dysfunction has been
observed in the present study late after aortic valve replacement. This finding has been
explained by incomplete regression of the extra-cellular matrix 7 years after valve
replacement. Interstitial fibrosis remains unchanged compared to the preoperative situation
but was increased early after operation due to the reduction in LV muscle mass. Regression
of LV hypertrophy was 40% after 2 and 55% after 7 years of valve replacement. Myocardial
muscle fibers decreased slightly but remained hypertrophied even late after operation.
Interstitital fibrosis was found to be positively correlated to myocardial stiffness and
inversely to LV ejection fraction.
Thus, persistent diastolic dysfunction with maintained systolic ejection performance can be
observed late after successful valve replacement in patients with severe aortic
regurgitation. Altered diastolic function has been associated with increased filling
pressures during strenuous exercise with signs of dyspnea.
Objective
Evaluation of myocardial structure and function in patients with chronic volume overload
before and after valve replacement(LV-remodeling).
Methods
Pressure-volume measurements and myocardial biopsy samples for assessing myocardial function
and structure.
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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