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Updated: Jan 28, 2026
Studying Left Ventricular Reverse Remodeling by Aortic Debanding in Rodents
Published on: July 14, 2021
Remodeling classification system considering left ventricular volume in patients with aortic valve stenosis:
Andrea Barbieri1, Ylenia Bartolacelli1, Francesca Bursi1,2
1Division of Cardiology, Department of Diagnostics, Clinical and Public Health Medicine, Policlinico University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy.
Insights
Left ventricular (LV) remodeling in aortic valve stenosis (AS) is common, with dilated LVH and concentric remodeling predicting worse outcomes. Early identification of these patterns is crucial for managing AS patients.
Area of Science:
- Cardiology
- Cardiac Imaging
- Heart Failure Research
Background:
- Aortic valve stenosis (AS) is a significant cardiovascular condition.
- Left ventricular (LV) remodeling, encompassing changes in volume, mass, and wall thickness, is a key factor in AS progression.
- Understanding the prevalence and implications of different LV remodeling patterns is essential for patient management.
Purpose of the Study:
- To assess the prevalence of various left ventricular (LV) remodeling patterns in patients diagnosed with aortic valve stenosis (AS).
- To evaluate the clinical implications and prognostic significance of these LV remodeling patterns on patient outcomes.
- To analyze the association between LV geometric patterns and hemodynamic profiles in AS.
Main Methods:
- Retrospective analysis of 343 patients with functional aortic valve area (AVA) ≤ 1.5 cm².
- Classification of LV geometric patterns based on volume, mass, and relative wall thickness.
- Evaluation of clinical outcomes, including combined death, cardiac hospitalization, and aortic valve replacement (AVR).
- Statistical analysis including multivariable adjustment to identify predictors of adverse events.
Main Results:
- A minority of AS patients (4.9%) exhibited normal LV geometry; most showed various forms of remodeling or hypertrophy.
- Indexed stroke volume varied significantly across different LV geometric patterns.
- A significant association was found between LV dilation, remodeling patterns, and adverse clinical outcomes (75.8% experienced the combined endpoint).
- Concentric remodeling and dilated LVH were strongly associated with increased risk of death or cardiac hospitalizations after multivariable adjustment.
Conclusions:
- The novel LV remodeling classification reveals that normal geometry is rare in AS patients with AVA ≤ 1.5 cm².
- LV volume dilatation is frequent and linked to adverse outcomes.
- Specific remodeling patterns, including concentric remodeling, eccentric remodeling, and dilated LVH, are associated with the poorest hemodynamic profiles and prognoses, highlighting their clinical importance.
Background:
To assess prevalence and clinical implications of left ventricular (LV) remodeling considering: LV volume, mass and relative wall thickness at the time of aortic valve stenosis diagnosis.
Methods And Results:
We retrospectively analyzed 343 patients (age 79.2 ± 9.5 years, 48.1% males) with functional aortic valve area (AVA) ≤ 1.5 cm2 . LV geometric patterns and clinical outcomes (combined death, cardiac hospitalization, aortic valve replacement [AVR]) were evaluated. According to the new LV remodeling classification, 4.9% had normal geometry, 7.5% concentric remodeling, 39.3% concentric hypertrophy (LVH), 22.4% mixed LVH, 12.5% dilated LVH, 3.2% eccentric LVH and 4.3% eccentric remodeling, 5.5% had not classifiable LVH. Indexed stroke volume (SVi) was higher in patients with concentric LVH (40.3 ± 11.9 mL/m2 ) and mixed LVH (41.6 ± 13.4 mL/m2 ) and lower in patients with eccentric LVH (24.9 ± 7.7 mL/m2 ), concentric (36.6 ± 12.7 mL/m2 ) and eccentric remodeling (34.9 ± 9.5 mL/m2 ), P = 0.003. During a median follow-up of 2.2 years, 260 (75.8%) had the combined end point. A significant association between the combined end point and LV dilation (P = 0.010) or LV remodeling patterns (P = 0.0001) was found. After multivariable adjustment for AVR, concentric remodeling (HR 3.12, IC 95% 1.14-8.55; P = 0.02) and dilated LVH (HR 3.48, IC 95% 1.31-9.27; P = 0.01) were strongly associated with death or cardiac hospitalizations.
Conclusions:
In patients with AVA ≤ 1.5 cm2 , when the new LV remodeling classification system is applied, only a minority had normal geometry and less than half had "classic" concentric LVH or remodeling. LV volume dilatation is frequent and associated with adverse outcome. Concentric remodeling, eccentric remodeling, dilated LVH had the worst noninvasive hemodynamic profile and prognosis.
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