The aim of this study was to determine whether cardiac remodeling and clinical outcomes after aortic valve replacement (AVR) could be predicted by simple preoperative electrocardiographic analysis.

In a single-center, from January 2005 to January 2015, we retrospectively analyzed the clinical data of 50 patients with pure chronic aortic regurgitation (AR) who had underwent AVR. Based on the presence or absence of early left ventricular (LV) diastolic remodeling, the patients were divided into 2 groups. Early diastolic remodeling was defined as an early postoperative LV diastolic dimension reduction of 10% or more, while non-remodeling group was early postoperative LV diastolic dimension decreased less than 10%.

Forty patients (82%) had positive early LV remodeling after AVR. The amplitude of S wave in the right thoracic lead decreased significantly in the left ventricular remodeling group (P<0.001) . The amplitude of S wave ≤ 2.9 mV was the predictor of late postoperative when left ventricular ejection fraction (LVEF) was >45% (sensitivity 90% and specificity 90%) applied ultrasound measurement at (1.7±1.1) years. Patients with an amplitude of S wave>2.9 mV had higher heart failure prehospitalization and all-cause mortality (P<0.001) during mean 601 days follow-up.

S wave amplitude of V₂ lead before AVR in patients with chronic AR is associated with early left ventricular remodeling and advanced prognosis.

Electrocardiography; Aortic regurgitation; Aortic valve replacement; S-wave magnitude