| Introduction: Patients with aortic valve stenosis and/or aortic regurgitation are subjected to increased pressure and/or volume load of the left ventricle, leading to either dilatation or hypertrophy of left ventricle. Long time of left ventricular dilatation and/or hypertrophy can cause pathologic impairment of myocardium, and is associated with systolic and/or diastolic dysfunction. Correction of the abnormal hemodynamic burden by aortic valve replacement can result a reversal of left ventricular dilatation and hypertrophy and improvement of heart function. In order to assess the reversability of left ventricular dilatation, hypertrophy and dysfunction of different underlying aortic disease after aortic valve replacement, 51 consecutive patients were followed preoperatively, earlyand intermediate after a successful aortic valve replacement with serial echocardiograms.Material and Methods: 51 consecutive patients (study group) underwent isolated aortic valve replacement during Jan. 1997 and Dec.2003 were analyzed retrospectively with serial echocardiograms. 15 patients without cardiac disease served as control group. Transthoracic Doppler echocardiography were performed for study group on the day less than one month before operation, early (3weeks~6months post operation) and intermediate (l~2years post operation) after operation to assess the configuration and function of left ventricle. The following parameters were measured: left ventricular end-diastolic diameter and end-systolic diameter; systolic and diastolic thickness of interventricular septum and posterior wall of left ventricle; left ventricular ejection fraction and fractional shortening. Quantitative data is given as mean standard deviation. One-Way ANOVA and Independent-Sample T Test were used for statistic analysis with package of SPSS 11.0 for windows.Results: The study group were divided into aortic insufficiency (AI, 28 patients), stenosis (AS, 10 patients) and combined (AI+AS, 13 patients) subgroups, according to the preexisting aortic valve disease. After operation, left ventricular end diastolic diameter (LVEDD) reduced all inthree subgroups, but it was more significant in AI subgroup than AS or AI+AS. If the patients were grouped according to preoperative LVEDD into extremely dilated left ventricle (LVEDD 70mm, 13 patients) and non-extremely dilated left ventricle (LVEDD<70mm, 38 patients) groups. The LVEDD of two groups were reduced both early and intermediate after aortic valve replacement. The LVEDD of extremely dilated groupdecreased dramatically from 78.2 8.0mm preoperatively to 54.3 + 6.5 mmand 55.9 + 6.9 mm early and intermediate after operation respectively, which were larger than corresponding stage of non-extremely dilated group (P<0.01). If the patients were grouped according to the preoperative left ventricular ejection fraction (LVEF) into normal LV function (LVEF 50%, 39 patients) and LV dysfunction (LVEF<50%, 12 patients) group, preoperative LVEDD of dysfunction group was larger than normal function group, but it reduced more quickly in dysfunction group, and amounting to which of the normal function group in the intermediate stage. Regression of posterior wall thickness of left ventricle was observed only in aortic stenosis group early after operation (14.2 + 2.2 mm vs 11.5+ 2.2mm, P<0.05). The preoperative LVEF and fractional shortening (FS) were lower than control group in all preexisting aortic valve disease. They increased after operation in all three subgroups whereas significantly only in AIgroup (P<0.001) .The postoperative LVEF of extremely dilated group was lower than that of non-extremely dilated group though it increased more quickly in extremely dilated group. The LVEF of LV dysfunction group was lower than that of normal function group though it increased more quickly after operation. Conclusions:1. The benefit of aortic valve replacement is different according to the type of preexisting valve disease (aortic insufficiency, stenosis or combined disease). Predominant aortic insu...
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