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Left Ventricular Concentric Geometric Patterns Are Associated With Worse Prognosis Among Patients With Type-A Aortic

Walter E M Rocha1, Matheus F R A Oliveira1, Julia D Soares2

  • 1Department of Internal Medicine School of Medical Sciences State University of Campinas São Paulo Brazil.

Journal of the American Heart Association
|February 18, 2021
PubMed

Insights

Left ventricular remodeling patterns predict mortality in aortic dissection. Concentric patterns are linked to higher mortality in type A aortic dissection, but not in type B.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Thoracic Surgery

Background:

  • Aortic dissection (AD) involves different types (A and B) with varying prognoses.
  • Left ventricular (LV) remodeling, including hypertrophy and geometric patterns, may influence AD outcomes.
  • Predictive markers for mortality in AD are crucial for patient management.

Purpose of the Study:

  • To compare LV characteristics between type A and type B AD patients.
  • To assess the predictive ability of LV remodeling phenotypes for mortality in both AD types.
  • To identify specific LV geometric patterns associated with adverse prognosis.

Main Methods:

  • Retrospective analysis of 356 patients (236 type A, 120 type B AD) with echocardiograms near diagnosis.
  • Stratification of patients based on LV remodeling phenotypes (hypertrophy, concentricity, geometry).
  • Assessment of early (90-day) and late (1-year) mortality using multivariable Cox-regression and logistic regression analyses.

Main Results:

  • Type A AD patients showed higher odds of concentric hypertrophy and lower odds of eccentric hypertrophy compared to type B.
  • LV remodeling phenotypes did not predict mortality in type B AD.
  • LV concentricity was associated with increased early and late mortality in type A AD.
  • LV concentric remodeling and concentric hypertrophy predicted early mortality in type A AD.
  • LV concentric remodeling predicted late mortality in type A AD.
  • LV geometric patterns provided incremental prognostic value beyond clinical variables in type A AD.

Conclusions:

  • LV geometric patterns, particularly concentricity, are associated with increased mortality in type A AD.
  • LV remodeling phenotypes may serve as adverse prognostic markers in type A aortic dissection.
  • Further research is warranted to explore the clinical implications of these findings for type A AD management.

Keywords:
aortic dissectionconcentricityechocardiogramhypertrophyleft ventricular remodeling

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