Left ventricular reverse remodeling after aortic valve surgery for acute versus chronic aortic regurgitation

Aims Extent of left ventricular ( LV ) reverse remodeling after aortic valve repair or replacement ( AVR ) may differ between patients operated for acute aortic regurgitation ( AR ) and chronic AR . The aim of this study was to compare changes in LV volumes and function between patients with acute and chronic AR who underwent AVR . Methods and Results A total of 98 patients (54±15 years, 61% men) with acute (n=21) or chronic AR (n=77) were included in the present retrospective evaluation. LV volumes, LV ejection fraction, and global longitudinal strain indexed for LV end‐diastolic volume ( GLS i) were assessed preoperatively and after a median follow‐up of 28 months (interquartile range: 17–66 months). Patients with acute AR tended to have smaller preoperative LV end‐diastolic volume compared with chronic AR (156±15 vs 183±6 mL; P =.070). Both in patients with acute and chronic AR , significant LV reverse remodeling with sustained reduction in LV volumes occurred during follow‐up with a significant smaller LV end‐diastolic volume in acute AR compared with chronic AR (106±8 vs 128±5 mL; P =.032). Preoperative and postoperative LV ejection fractions were not significantly different between groups. In contrast, GLS i was better in patients with acute AR compared with chronic AR before AVR (−1.34±0.20 vs −0.96±0.07%/10 mL; P =.042) and during follow‐up (−1.65±0.16 vs −1.29±0.07%/10 mL; P =.017). Conclusions After AVR , LV reverse remodeling occurs both in patients with acute and chronic AR . However, LV end‐diastolic volume was more reduced and GLS i was more preserved during follow‐up in acute AR than in chronic AR .