To evaluate the value of Doppler-derived dP/dt as a predictor of postoperative left ventricular (LV) systolic function in patients with chronic aortic regurgitation, we evaluated 29 patients who underwent aortic valve replacement (n = 17) or valve repair. Doppler-derived dP/dt was determined from the continuous wave Doppler signal of the aortic regurgitation jet preoperatively. Preoperative LV ejection fraction (LVEF) and Doppler-derived dP/dt were 48 +/- 11% and 701 +/- 204 mm Hg/s, respectively. LVEF decreased to 43 +/- 12% at immediate postoperative period and improved to 54 +/- 11% at late postoperative period. In multivariate analysis, only dP/dt was an independent predictor of late postoperative LVEF (r = 0.59, P =.006). A dP/dt <or=700 mm Hg/s was the best predictor of late postoperative systolic dysfunction (LVEF <50%) with a sensitivity of 94% and a specificity of 75%. Doppler-derived dP/dt may be useful to predict postoperative LV systolic function.