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[The applicability of systolic time intervals in patients before and after aortic valve replacement (author's transl)].

In order to evaluate the systolic time intervals (STI) for characterizing the left ventricular pump function and the clinical course in patients with aortic valve disease, 35 patients with aortic stenosis (AS) and 25 patients with aortic insufficiency (AI class III or IV (NYHA) were studied before and 1 year after valve replacement either with Björk-Shiley, Lillehie-Kaster or Starr-Edwards aortic prostheses. Left ventricular ejection time index (LVETI), preejection period index (PEPI) and PEP/LVET were determined and compared with cardiac index (CI), stroke volume index (SVI) and ejection fraction (EF). Prosthetic valve replacement leads to a high significant decrease of LVETI from preop. 468 +/- 31 ms to postop. 394 +/- 26 ms (mean normal values 415 ms) and an increase of PEPI from 100 +/- 26 ms to 136 +/- 25 ms (normal 132 ms) as of PEP/LVET from 0.21 +/- 0.09 to 0.41 +/- 0.12 (normal 0.31). Pre- as well as postop. there is no difference in STI between AS and AI. Also the groups with the three prosthetic valve types do not differ significantly. LVETI and PEPI correlate only postop. with CI and SVI, but PEP/LVET correlates well with EF (r = -0.73) before and after operation. The comparison of STI with the hemodynamic data suggest that preop. values of STI near normal and postop. LVETI below, PEPI and PEP/LVET above the mean values of the whole group with aortic valve replacement indicate left ventricular pump dysfunction. The STI are helpful in the pre-/postop. follow-op of patients with severe aortic valve disease to characterize the clinical and hemodynamic course.

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