Taniguchi K, Nakano S, Hirose H, Matsuda H, Shirakura R, Sakai K, Kawamoto T, Sakaki S, Kawashima Y
J Am Coll Cardiol. 1987 Sep;10(3):510-8. doi: 10.1016/s0735-1097(87)80192-4.
Postoperative survival and left ventricular function were studied in 62 patients who underwent aortic valve replacement for isolated, chronic aortic regurgitation between 1978 and 1985. The average follow-up period was 3.8 years. There were three in-hospital and six late deaths. Five (56%) of the nine postoperative deaths were of cardiac-related causes. The mean 7 year survival rate was 83 +/- 5%. Preoperative left ventricular end-systolic volume index was the most important indicator (p less than 0.001) for subsequent cardiac death. The 6.5 year survival rate was 92 +/- 4% for patients with an end-systolic volume index less than 200 ml/m2 compared with 51 +/- 16% for those whose index was greater than 200 ml/m2. None of the 48 patients with an end-systolic volume index less than 200 ml/m2 died of cardiac-related causes. Twenty-three of the 48 patients with an end-systolic volume index less than 200 ml/m2 (Group 1) and 6 of the 12 patients with a higher index (Group 2) underwent repeat catheterization 26 months postoperatively. Preoperative afterload, assessed by end-systolic wall stress, was elevated in both groups, but decreased postoperatively, becoming identical to the afterload in 20 normal control subjects. Although the preoperative ejection fraction was depressed in both groups, the great majority of patients in Group 1, compared with none in Group 2, exhibited normal ejection fraction postoperatively. Thus, in patients who recently underwent surgery for aortic regurgitation, satisfactory late results in both long-term survival and reversal of left ventricular dysfunction were obtained when the preoperative end-systolic volume index was less than 200 ml/m2.
对1978年至1985年间因单纯慢性主动脉瓣反流而接受主动脉瓣置换术的62例患者的术后生存率和左心室功能进行了研究。平均随访期为3.8年。有3例住院死亡和6例晚期死亡。9例术后死亡中有5例（56%）与心脏相关原因有关。平均7年生存率为83±5%。术前左心室收缩末期容积指数是随后心脏死亡的最重要指标（p<0.001）。收缩末期容积指数小于200 ml/m²的患者6.5年生存率为92±4%，而指数大于200 ml/m²的患者为51±16%。收缩末期容积指数小于200 ml/m²的48例患者中无一例死于心脏相关原因。收缩末期容积指数小于200 ml/m²的48例患者中的23例（第1组）和指数较高的12例患者中的6例（第2组）在术后26个月接受了重复导管检查。通过收缩末期壁应力评估的术前后负荷在两组中均升高，但术后降低，与20名正常对照受试者的后负荷相同。虽然两组术前射血分数均降低，但与第2组无一例患者相比，第1组绝大多数患者术后射血分数正常。因此，在最近接受主动脉瓣反流手术的患者中，当术前收缩末期容积指数小于200 ml/m²时，在长期生存和左心室功能障碍逆转方面均获得了满意的晚期结果。
