Severe Aortic Stenosis: Reverse Cardiac Remodeling after Surgical Aortic Valve Replacement.

Context: Aortic stenosis (AS) induces ventricular remodeling. After surgical aortic valve replacement (SAVR), there is reverse remodeling (RR) that might impact patients' prognosis.

Aims: This study aims to characterize cardiac RR post-SAVR, determine possible explanatory factors of this phenomenon, and assess its prognostic impact.

Methods: A retrospective observational study of 114 patients with severe AS who underwent SAVR between 2017 and 2021 and had echocardiographic follow-up 1 year after. A descriptive analysis of baseline characteristics of the patients was carried out, pre- and post-surgical comparisons. Factors associated with left ventricular RR (LVRR) and time to the occurrence of a major adverse cardiac event (MACE) were assessed.

Results: A total of 114 patients were included, with a median age of 72 years. One-year post-SAVR the left ventricle mass index (LVMi) decreased 16.9% (P < 0.01), the functional class improved (patients in New York Heart Association (NYHA) class I post-SAVR 57, 9% vs. patients in NYHA class I pre-SAVR 11, 4%; P < 0.01) and electrocardiographic criteria for hypertrophy were less common (19% post-SAVR vs. 43% pre-SAVR, P < 0.01). Basal LVMi was the only independent predictor of LVMi 1-year post-SAVR (B = 0.51 IC95% (0.34-0.68); P < 0.01). In the multivariate analysis, only age was associated with the occurrence of a MACE, hazard ratio = 1.11 (P = 0.026).

Conclusions: Results suggest that 1-year post-SAVR there is LVRR and basal LVMi is the only independent predictor of this phenomenon. Age is the only identified risk factor associated with the occurrence of a MACE, while no association was found between the latest and LVRR.