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Late Cardiac Deaths After Isolated Valve Replacement for Aortic Stenosis. Relation to Impaired Left Ventricular Diastolic Performance

Ole Lund

Department of Thoracic and Cardiovascular Surgery, Skejby Sygehus/Aarhus University Hospital, Aarhus N

Finn Taagehøj Jensen

Department of Clinical Physiology and Nuclear Medicine, Aarhus Kommunehospital/University Hospital, Aarhus C, Denmark

Sixty-three patients took part in a follow-up study ten to seventeen years after valve replacement for aortic stenosis. Data obtained were used to predict cardiac deaths (n = 14) occurring in the following three-year period. The degree of residual left ventricular (LV) hypertrophy correl ated inversely with indices for LV sys tolic and diastolic performance (radionuclide cardiography). A logis tic regression (LR) model had a posi tive predictive value for cardiac deaths of 100% (10/10) with 8% (4/53) false negatives. Evaluating LV performance indices exclusively, LR analysis showed that only peak filling rate had independent predictive value. Subnormal and normal LV ejection fractions were associated with equal three-year cardiac death rates (29%).

Depressed LV function was re lated to residual hypertrophy. Im paired diastolic performance was the prime predictor of cardiac deaths.

Angiology, Vol. 40, No. 3, 199-208 (1989)
DOI: 10.1177/000331978904000308
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