Factors affecting left ventricular remodeling after valve replacement for aortic stenosis. An overview

<p>Abstract</p> <p>Although a small percentage of patients with critical aortic stenosis do not develop left ventricle hypertrophy, increased ventricular mass is widely observed in conditions of increased afterload. There is growing epidemiological evidence that hypertrophy is asso...

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Main Authors: Mhagna Zen, Tomba Margherita, Brunelli Federico, Cirillo Marco, Troise Giovanni, Villa Emmanuel, Tasca Giordano, Quaini Eugenio
Format: Article
Language:English
Published: BMC 2006-06-01
Series:Cardiovascular Ultrasound
Online Access:http://www.cardiovascularultrasound.com/content/4/1/25
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author Mhagna Zen
Tomba Margherita
Brunelli Federico
Cirillo Marco
Troise Giovanni
Villa Emmanuel
Tasca Giordano
Quaini Eugenio
author_facet Mhagna Zen
Tomba Margherita
Brunelli Federico
Cirillo Marco
Troise Giovanni
Villa Emmanuel
Tasca Giordano
Quaini Eugenio
author_sort Mhagna Zen
collection DOAJ
description <p>Abstract</p> <p>Although a small percentage of patients with critical aortic stenosis do not develop left ventricle hypertrophy, increased ventricular mass is widely observed in conditions of increased afterload. There is growing epidemiological evidence that hypertrophy is associated with excess cardiac mortality and morbidity not only in patients with arterial hypertension, but also in those undergoing aortic valve replacement. Valve replacement surgery relieves the aortic obstruction and prolongs the life of many patients, but favorable or adverse left ventricular remodeling is affected by a large number of factors whose specific roles are still a subject of debate. Age, gender, hemodynamic factors, prosthetic valve types, myocyte alterations, interstitial structures, blood pressure control and ethnicity can all influence the process of left ventricle mass regression, and myocardial metabolism and coronary artery circulation are also involved in the changes occurring after aortic valve replacement. The aim of this overview is to analyze these factors in the light of our experience, elucidate the important question of prosthesis-patient mismatch by considering the method of effective orifice area, and discuss surgical timings and techniques that can improve the management of patients with aortic valve stenosis and maximize the probability of mass regression.</p>
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spelling doaj.art-c599a0ab776148a0bd31c11d5c0cb3c02022-12-22T03:05:15ZengBMCCardiovascular Ultrasound1476-71202006-06-01412510.1186/1476-7120-4-25Factors affecting left ventricular remodeling after valve replacement for aortic stenosis. An overviewMhagna ZenTomba MargheritaBrunelli FedericoCirillo MarcoTroise GiovanniVilla EmmanuelTasca GiordanoQuaini Eugenio<p>Abstract</p> <p>Although a small percentage of patients with critical aortic stenosis do not develop left ventricle hypertrophy, increased ventricular mass is widely observed in conditions of increased afterload. There is growing epidemiological evidence that hypertrophy is associated with excess cardiac mortality and morbidity not only in patients with arterial hypertension, but also in those undergoing aortic valve replacement. Valve replacement surgery relieves the aortic obstruction and prolongs the life of many patients, but favorable or adverse left ventricular remodeling is affected by a large number of factors whose specific roles are still a subject of debate. Age, gender, hemodynamic factors, prosthetic valve types, myocyte alterations, interstitial structures, blood pressure control and ethnicity can all influence the process of left ventricle mass regression, and myocardial metabolism and coronary artery circulation are also involved in the changes occurring after aortic valve replacement. The aim of this overview is to analyze these factors in the light of our experience, elucidate the important question of prosthesis-patient mismatch by considering the method of effective orifice area, and discuss surgical timings and techniques that can improve the management of patients with aortic valve stenosis and maximize the probability of mass regression.</p>http://www.cardiovascularultrasound.com/content/4/1/25
spellingShingle Mhagna Zen
Tomba Margherita
Brunelli Federico
Cirillo Marco
Troise Giovanni
Villa Emmanuel
Tasca Giordano
Quaini Eugenio
Factors affecting left ventricular remodeling after valve replacement for aortic stenosis. An overview
Cardiovascular Ultrasound
title Factors affecting left ventricular remodeling after valve replacement for aortic stenosis. An overview
title_full Factors affecting left ventricular remodeling after valve replacement for aortic stenosis. An overview
title_fullStr Factors affecting left ventricular remodeling after valve replacement for aortic stenosis. An overview
title_full_unstemmed Factors affecting left ventricular remodeling after valve replacement for aortic stenosis. An overview
title_short Factors affecting left ventricular remodeling after valve replacement for aortic stenosis. An overview
title_sort factors affecting left ventricular remodeling after valve replacement for aortic stenosis an overview
url http://www.cardiovascularultrasound.com/content/4/1/25
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