CC Cardiol Croat Cardiologia Croatica Cardiol. Croat. 1848-543X 1848-5448 Croatian Cardiac Society CC_13(11-12)_379 10.15836/ccar2018.379 Extended Abstract Reversal of left ventricular mass and global longitudinal strain in patients with severe aortic valve stenosis at three-month follow-up after aortic valve surgery replacement Smanjenje mase lijeve klijetke i globalne longitudinalne deformacije u bolesnika s teškom aortnom stenozom tri mjeseca nakon zamjene aortne valvule https://orcid.org/0000-0002-2637-9691JurinIvana1*https://orcid.org/0000-0001-6602-699XVarvodićJosip1https://orcid.org/0000-0002-9644-9739ŠušnjarDubravka1https://orcid.org/0000-0001-9139-5009HadžibegovićIrzal1https://orcid.org/0000-0002-2036-1239SvagušaTomo1https://orcid.org/0000-0003-1229-7983LetilovićTomislav2https://orcid.org/0000-0003-2183-3506RadošStipe1https://orcid.org/0000-0001-6613-9492TičinovićNino1https://orcid.org/0000-0002-0876-6217GrgurićJasenka3https://orcid.org/0000-0001-9688-8582PaićFrane3https://orcid.org/0000-0002-7735-6721RudežIgor1 Klinička bolnica Dubrava, Zagreb, Hrvatska Klinička bolnica Merkur, Zagreb, Hrvatska Medicinski fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska University Hospital Dubrava, Zagreb, Croatia University Hospital “Merkur”, Zagreb, Croatia University of Zagreb, School of Medicine, Zagreb, Croatia ADDRESS FOR CORRESPONDENCE: Ivana Jurin, Klinička bolnica Dubrava, Avenija Gojka Šuška 6, HR-10000 Zagreb, Croatia. / Phone: +385-98-559387 / E-mail: ivanajurin1912@gmail.com 112018 13 11-12 379 379 2810201805112018 2018 Croatian Cardiac Society KLJUČNE RIJEČI: aortna stenozazamjena aortne valvulemasa lijeve klijetkeglobalna longitudinalna deformacija KEYWORDS: aortic stenosisaortic valve replacementleft ventricular mass indexglobal longitudinal strain

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 to 169.18±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 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.

LITERATURE VizzardiESciattiEBonadeiIRovettaRD’AloiaAGelsominoS 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):253–61.25436207