ABSTRACT
This chapter examines reported changes in left ventricular (LV) size (volumes and/or dimension), function, and mass after valve replacement/repair, a process that has been termed LV “reverse remodeling”. Moreover, all techniques that measure LV mass include myocardium, blood vessels, connective tissue, and fibrous tissue. Despite the technique related problems, the factors that affect reverse ventricular remodeling after valve surgery can be divided into preoperative, operative, and postoperative. The mechanisms of reverse remodeling can be divided into four categories: mechanical, molecular, neurohormonal, and metabolic. The tissue changes that develop in response to the altered loading conditions, imposed by a valve lesion, strongly influence reverse remodeling after valve surgery. The type of prosthetic heart valve and its size do not appear to affect reverse ventricular remodeling. The extent of remodeling that develops in response to aortic regurgitation is an important predictor of the long-term postoperative clinical course.
