Impact of moderate coronary atherosclerosis on long-term left ventricular remodeling after aortic valve replacemen.

BACKGROUND

The role of coronary atherosclerosis (CA+) in ventricular remodeling after aortic valve replacement (AVR) for isolated aortic stenosis (AS) is not well defined. We sought to evaluate the impact of not revascularized moderate coronary atherosclerosis in long-term left ventricular (LV) remodeling after AVR.

METHODS

We assessed by coronariography the coronary artery disease in 66 patients referred for AVR and evaluated morphological and functional LV data by echocardiography both preoperatively and postoperatively (3 ± 1.2 years).

RESULTS

In patients without coronary atherosclerosis, hypertrophy regression was more intense and the absolute reverse remodeling was higher in LV mass index (-55.8 ± 36 g/m² vs -28.4 ± 34 g/m², p = 0.004), reduction of LV dimensions (LV end-diastolic diameter [LVEDD]: -4.1 ± 7.4 mm vs -2.2 ± 8.3 mm, p = 0.04), and regression of wall thickness (interventricular septum [IVS]: -3.3 ± 2.6 mm vs -1.6 ± 2.2 mm, p = 0.01; and posterior wall thickness [PWT]: -2.1 ± 2.1 mm vs 0.6 ± 2.1 mm, p = 0.012).

CONCLUSIONS

After AVR for AS, not revascularized moderate coronary atherosclerosis determines a long-term lesser degree of LV hypertrophy regression and a worse absolute reverse remodeling of LV mass index, LVEDD, IVS and PWT.