[Postoperative changes in left ventricular systolic function in patients with aortic valve stenosis]. / Postoperativne promene sistolne funkcije leve komore kod bolesnika sa stenozom aortne valvule.

Left ventricular systolic function in aortic stenosis remains intact for long period due to myocardial hypertrophy. Aim of this study was postoperative follow-up of the left ventricular systolic function both in patients with preserved and with decreased systolic performance. The study comprised 78 patients with severe and moderate aortic valve stenosis, out of whom 42 patients underwent surgery. In the majority of patients (88.1%) systolic function was improved, both in patients with preoperatively preserved systolic performance, and those who were with decreased systolic performance before the surgery. Systolic function was not improved in only 4.8%, while 3 (7.1%) patients died. Systolic function was improved mainly in the patients in whom systolic function disturbance was caused by the increase of afterload, and less frequently in patients with the decrease in myocardial contractility.

[Echocardiographic evaluation of left ventricular diastolic function in patients with aortic valve stenosis]. / Ehokardiografska procena dijastolne funkcije leve komore kod bolesnika sa stenozom aortne valvule.

Impairment of left ventricular diastolic function in aortic valve stenosis occurs very early and precedes the impairment of systolic function. Aim was to examine left ventricular diastolic function and its association with severity of myocardial hypertrophy and clinical picture. The paper comprised 78 patients with isolated aortic valve stenosis in whom were performed ultrasonography and catheterization. No significant differences in parameters of diastolic filling were observed in patients with mild hypertrophy and preserved systolic function compared to healthy subjects. In patients with moderate myocardial hypertrophy, left ventricular filling was decreased in an early diastole (Emax 51 +/- 5 cm/s, Evti 6.4 +/- 1.1 cm) and increased in late diastole (Amax 88 +/- 11 cm/s, Avti 11.4 +/- 1.8 cm), while deceleration time was prolonged (DT 171 +/- 32 ms). Pulmonary vein flow was decreased during diastole (Dmax 33 +/- 5 cm/s, Dvti 7.6 +/- 2 cm). Pseudonormalization of flow through mitral valve was observed in patients with pronounced hypertrophy of left ventricular wall (mass > 180 g/m2): increase of the velocity during the phase of fast left ventricular filling (Emax 72 +/- 13 cm/s, Evti 9.8 +/- 2.1 cm), decrease during atrial contraction (Amax 31 +/- 6 cm/s, Avti 3.7 +/- 0.4 cm), reduction in deceleration time (DT 116 +/- 11 ms), while pulmonary vein flow velocity was increased during the early diastole (Dmax 64 +/- 17 cm/s, Dvti 10.7 +/- 2.2 cm). Likewise, significant correlation between clinical picture and type of blood flow through mitral valve was observed.