Type II Diabetes Influence on Left Ventricular Remodeling and Outcomes in Patients Undergoing Aortic Valve Replacement Surgery.
Type II Diabetes Influence on Left Ventricular Remodeling and Outcomes in Patients Undergoing Aortic Valve Replacement Surgery.
This project focuses on the physiopathology of left ventricular remodeling associated with
 type II diabetes in patients with aortic valve stenosis referred for surgical aortic valve
 replacement.

 The main objective is to compare the reverse left ventricular remodeling between patients
 with type II diabetes and case-control patients without diabetes at one(1) year after
 surgical aortic valve replacement.

 The secondary objectives are :

 1. assess the influence of type II diabetes on left ventricular remodeling in patients
 presenting with aortic valve stenosis,

 2. assess the predictive value of myocardial fibrosis and other LV characteristics present
 prior to aortic valve surgery on the LV reverse remodeling and their influence on
 cardiovascular events at one (1) year after surgery,

 3. assess the influence of type II diabetes on cardiovascular morbidity and mortality post
 aortic valve surgery.

 The investigators main hypothesis is that patients with type II diabetes and aortic valve
 stenosis requiring aortic valve replacement have poorer LV function and less favorable post
 surgery clinical outcomes than patients without type II diabetes.
Inclusion Criteria:

 -  Age > 18 years

 -  Arm 1: Treated Type II diabetes, Arm 2: absence of type II diabetes

 -  Aortic valve stenosis

 -  LVEF > 50% with no kinetic abnormalities

 -  Non significant obstructive coronary artery disease

 -  Absence of gadolinium enhanced MRI contraindications

 -  Informed consent signed

 -  Patient affiliated to the French Social Security.

 Exclusion Criteria:

 -  Chronic arrhythmia or absence of sinus rhythm

 -  Past history of cardiomyopathy or coronary insufficiency

 -  Significant coronaropathy seen during the coronary angiography with >50% degree
 stenosis prior to aortic valve replacement

 -  Hemodynamically significant valvular dysfunction other than aortic stenosis (grade 2
 mitral or aortic insufficiency, mitral valve stenosis < 1.5 cm2)

 -  Systemic chronic inflammatory disease leading to cardiac injury (scleroderma)

 -  Renal insufficiency (clearance < 30 ml/min)

 -  Insufficient transthoracic echocardiography echogenicity

 -  Type I diabetes mellitus

 -  Uncontrolled hypertension (> 180/100 mm Hg)