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Left Ventricular Hypertrophy Does Not Affect 1-Year Clinical Outcomes in Patients Undergoing Transcatheter

Anubodh S Varshney1, Pratik Manandhar2, Sreekanth Vemulapalli3

  • 1Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, Massachusetts.

JACC. Cardiovascular Interventions
|February 21, 2019
PubMed

Insights

Pre-procedural left ventricular hypertrophy (LVH) patterns did not significantly impact clinical outcomes after transcatheter aortic valve replacement (TAVR). This suggests TAVR benefits patients with severe aortic stenosis irrespective of their LVH status.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Interventional Cardiology

Background:

  • Left ventricular hypertrophy (LVH) is common in patients with severe aortic stenosis.
  • The impact of different LVH patterns on outcomes after transcatheter aortic valve replacement (TAVR) remains unclear.

Purpose of the Study:

  • To investigate the association between pre-procedural LVH patterns and clinical outcomes following TAVR.
  • To determine if LVH severity or type influences TAVR success rates.

Main Methods:

  • Analysis of a large cohort (n=31,199) from the TVT Registry linked to Medicare data.
  • Patients were categorized by LVH patterns (concentric remodeling, concentric LVH, eccentric LVH) using sex-specific criteria.
  • Multivariate hazard models assessed the association between LVH patterns and 1-year outcomes (mortality, MI, stroke, new dialysis).

Main Results:

  • No significant associations were found between any LVH pattern (concentric remodeling, concentric LVH, eccentric LVH) and adverse outcomes at 1-year follow-up.
  • Specific hazard ratios and confidence intervals for mortality, MI, stroke, and new dialysis did not show significant differences compared to patients without LVH.

Conclusions:

  • Pre-procedural LVH, assessed by left ventricular mass index and relative wall thickness, is not associated with adverse clinical outcomes 1 year after TAVR.
  • TAVR appears to be a beneficial treatment for severe aortic stenosis, regardless of the patient's LVH status.
Abstract

Keywords:
aortic stenosisleft ventricular hypertrophytranscatheter aortic valve replacement

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