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Ann Thorac Surg 2001;71:1154-1159
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Change of c-Myc expression and cardiac hypertrophy in patients with aortic valve replacement

Satoshi Taketani, MDa, Yoshiki Sawa, MDa, Hajime Ichikawa, MDa, Shigeaki Ohtake, MDa, Motonobu Nishimura, MDa, Naomasa Kawaguchi, MDb, Hikaru Matsuda, MDa

a Department of Surgery Course of Interventional Medicine (E1), Osaka University Graduate School of Medicine, Osaka, Japan
b Allied Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan

Accepted for publication November 19, 2000.

Address reprint requests to Dr Sawa, Department of Surgery Course of Interventional Medicine (E1), Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan

Background. Long-term volume overload to the left ventricle (LV) due to aortic regurgitation (AR) tends to cause severe impairment in LV function that cannot be reversed even with aortic valve replacement (AVR). Recently, we reported that the protooncogene c-myc is related to the onset of the cardiac hypertrophy and LV dysfunction in patients with chronic AR. However, it is still unclear whether c-myc is related to reversibility of the cardiac hypertrophy or LV dysfunction after AVR.

Methods and Results. Twenty patients with isolated chronic AR who underwent AVR were included in this study. LV function was calculated before and after AVR. After AVR, end-systolic volume index (ESVI) and end-diastolic volume index (EDVI) were improved, but not mass index (LVMI). However, normalization of ESVI and EDVI was observed only in 12 and 9 patients, respectively. Preoperatively, c-Myc protein was expressed in the myocardium of 16 out of 20 patients with an average point count of 35 ± 30%. After AVR, c-Myc protein was observed only in 2 patients. Preoperative ejection fraction (EF), ESVI, and postoperative end-systolic stress (ESS)/ESVI had significant correlation to postoperative cell diameter (CD). Percent c-Myc protein expression before the operation was significantly correlated to postoperative CD, ESVI, and ESS/ESVI. Average c-Myc expression was higher in patients who showed normalization of CD and ESS/ESVI after AVR than the patients who did not.

Conclusions. These data suggest that preoperative expression of c-Myc can be indicative of the reversibility of myocardial cellular hypertrophy and LV dysfunction.






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