الفهرس 
PATHOPHYSOLOGY OF AORTIC VALVE DISEASEOnly 14 pages are availabe for public view
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Abstract
Role of amlodipine in decreasing myocardial stunning after aortic valve replacement
Mahmoud MOHAMMED Zaki Ghalwash, M.B.B.ch, M.S.
Back ground and objectives:
An increasing evidence suggests that amlodipine therapy is beneficial to cardiac muscle of patients undergoing aortic valve replacement. In this study, amlodipine therapy will be shown to optimize cardiac preservation.
Methods:
60 patients have (AVR) enrolled in this non-randomized prospective study divided into 2 groups:
Group I: 21 males and 9 females with mean age (41.73 ± 14.49) receiving amlodipine.
Group II: 18 males and 12 females with mean age (40.6 ± 13.97) not receiving amlodipine.
Preoperative risk factors, operative data and postoperative details (including ICU time, postoperative complications and troponine I level, need for inotropic support and postoperative echocardiography) were recorded.
Results:
There was significant difference between the two groups in the following: 1-The heart started to beat after 4.77 ± 1.59 while in group II after 6.03 ± 2.23(P value=0.014).
2- No support was needed during come off bypass in 17(56.6%)patients,while in 8(26%)patients in group II(P value=0.018).
3- Inotropic support in ICU which was used in 13 (43.3%) patients in Group I and in 22 (73.3%) patients in Group II (P value =0.05)
4- The ejection fraction and fractional shortening after 3 days and two weeks postoperatively (P value <0.01).
5-After 24 hours troponin I in Group I was 2.029±0.287ug/lwhile in group II was 2.671 ±0.387ug/l(P value<0.01).After 48 hours in Group I,troponin I was 0.294±0.121ug/l while in Group II was 0.733±0.248ug/l(P value<0.01).
There was no significant difference regarding preoperative data,other intraoperative findings and other postoperative data (P value >0.05).
Conclusion:
The calcium antagonist amlodipine, given 5 to 7 days preoperatively at a dose of 5 mg orally , can be recommended for patients undergoing open-
heart surgery for isolated aortic valve disease with LV hypertrophy.
Key words: amlodipine, stunning,ejection fraction,fraction shortening,troponin I.