PMID- 2133725
OWN - NLM
STAT- MEDLINE
DCOM- 19920330
LR  - 20161123
IS  - 0914-5087 (Print)
IS  - 0914-5087 (Linking)
VI  - 20
IP  - 4
DP  - 1990
TI  - [Is the clinical course of non-rheumatic aortic regurgitation the same as that of 
      rheumatic aortic regurgitation?].
PG  - 905-15
AB  - To determine whether non-rheumatic (NR) aortic regurgitation (AR) has the same 
      clinical and postoperative courses as rheumatic (R) AR, we performed a 
      retrospective study using pre- and postoperative M-mode echocardiograms in 23 
      patients who underwent aortic valve replacement (AVR) under myocardial protection 
      with hypothermic cardioplegia. The etiology of AR was diagnosed by 
      two-dimensional echocardiography. The NR-AR group consisted of nine patients 
      including four with aortic valve prolapse (AP) and five with bicuspid valve (BV), 
      and the R-AR group included 14 patients. Patients with preoperative end-diastolic 
      dimensions (EDD) of less than 6.0 cm were excluded from this study. The 
      indication for AVR was NYHA functional class III or severer. The severity of 
      preoperative NYHA functional class was similar among these three groups. During 
      the 18-month follow-up period (range 2-32 months), there were no post-operative 
      deaths nor congestive heart failure. Ages at surgery ranged from 17 to 54 years; 
      10 (71%) of 14 patients with R-AR were 40 years old or older, while seven (78%) 
      of nine with NR-AR were under 39 years old (p less than 0.05). The pre-operative 
      left ventricular end-diastolic pressure (LVEDP) in patients with BV-AR was 
      highest among these three groups (R-AR: 14.5 +/- 3.9 mmHg, AP-AR: 9.5 +/- 4.1 
      mmHg, BV-AR: 22.0 +/- 2.7 mmHg, p less than 0.05). There was no significant 
      difference in pre-operative M-mode echocardiographic results, except for the 
      end-systolic dimension (ESD) between R-AR (5.20 +/- 0.55 cm) and BV-AR (4.78 +/- 
      0.18 cm) (p less than 0.05). The EDD one month after AVR was still abnormal 
      (greater than or equal to 5.4 cm) in seven of the 14 patients with R-AR, and 
      three of the four patients with AP-AR but none of the patients with BV-ARs (p 
      less than 0.05 vs AP-AR). All patients with pre-operative ESD of less than 5.2 cm 
      had normal EDD one month after AVR. In conclusion, the clinical course of NR-AR 
      is different from that of R-AR. Furthermore, AP-AR regresses more differently 
      after AVR than does BV-AR. Therefore, it is important to consider the etiology of 
      chronic AR in determining the timing of surgery.
FAU - Yoshino, H
AU  - Yoshino H
AD  - Department of Internal Medicine, Keio University School of Medicine, Tokyo.
FAU - Ogawa, S
AU  - Ogawa S
FAU - Nagata, M
AU  - Nagata M
FAU - Fujii, I
AU  - Fujii I
FAU - Ohnishi, S
AU  - Ohnishi S
FAU - Nishikawa, Y
AU  - Nishikawa Y
FAU - Tani, M
AU  - Tani M
FAU - Yamazaki, H
AU  - Yamazaki H
FAU - Handa, S
AU  - Handa S
FAU - Nakamura, Y
AU  - Nakamura Y
LA  - jpn
PT  - Comparative Study
PT  - Journal Article
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aortic Valve/surgery
MH  - Aortic Valve Insufficiency/diagnostic imaging/*physiopathology/surgery
MH  - Blood Pressure
MH  - Echocardiography
MH  - Follow-Up Studies
MH  - Heart Valve Prosthesis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - Retrospective Studies
MH  - Rheumatic Heart Disease/diagnostic imaging/*physiopathology/surgery
MH  - Ventricular Function
EDAT- 1990/01/01 00:00
MHDA- 1990/01/01 00:01
CRDT- 1990/01/01 00:00
PHST- 1990/01/01 00:00 [pubmed]
PHST- 1990/01/01 00:01 [medline]
PHST- 1990/01/01 00:00 [entrez]
PST - ppublish
SO  - J Cardiol. 1990;20(4):905-15.