Cardiac Remodelling
Postoperative cardiac remodeling data are summarized in Tables 3 and 4.
Both groups showed a significant reduction in peak and mean MV gradients
with males having an initial peak MV gradient of 18.5±10.2mmHg and a
postoperative gradient of 15.1±6.4mmHg (p=0.006). Females had an initial
MV peak gradient of 20.7±9.4mmHg to 16±5.8mmHg postoperatively
(p<0.001). Males began with a mean MV gradient from
8.6±6.8mmHg preoperatively to 5.7±2.9mmHg postoperatively (p=0.001), and
females had an initial mean gradient of 9.2±5.1mmHg and a postoperative
mean gradient of 5.7±2.8mmHg (p<0.001). Both groups were found
to have an increase in MVA after MVR with males having an initial MVA of
1.5±0.8cm2 and a post replacement area of
1.8±0.9cm2 (p<0.001), and females with an
initial MVA of 1.3±0.6cm2 and a postoperative MVA of
1.8±0.9cm2 (p<0.001). Only males
demonstrated significantly improved LV remodeling with an initial LVIDd
of 54.7±8.9mm and a postoperative LVIDd of 51.1±10.2 mm
(p<0.001). Initial LVIDd in females was 47.8±7.4mm, and
postoperatively it was 47.2±7.7mm (p=0.251). Males also showed a
significant reduction in LVEF with an initial LVEF of 51.9%±10.6% and
a postoperative LVEF of 49.2%±11.9% (p=0.003). Females did not
demonstrate the same reduction with an initial LVEF of 53.3%±10.6% and
a postoperative LVEF of 53.8%±11.5% (p=0.929). In contrast, it was
only females that demonstrated significantly improved LA remodeling.
Males had an initial LA volume index of 60±35.7ml/m2and a postoperative LA volume index of 60±28.8ml/m2(p=0.077), while females began with a LA volume index from 57.9
±24ml/m2 preoperatively to
55.6±20.8ml/m2 postoperatively (p=0.011). Females were
also the only group to show a significant reduction in LA diameter.
Males had an initial LA diameter of 5.4±1.2cm and a postoperative
diameter of 5.3±1.2cm (p=0.09). Females began with an LA diameter of
5.3±1.1cm and post MV replacement had an LA diameter of 5±0.9cm
(p=0.037). There were no significant differences in the absolute
anatomical changes between males and females (Table 4).