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Adverse Outcomes with Eccentric Hypertrophy in a Community Based University Cohort with Aortic Stenosis

Steven J Lavine1, Kirsten Raby2

  • 1Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States; Washington University of St. Louis, St. Louis, MO, United States.

The American Journal of the Medical Sciences
|August 17, 2021
PubMed

Insights

Aortic stenosis patients with eccentric left ventricular hypertrophy (Ecc-LVH) face increased risks of heart failure and all-cause mortality, particularly in moderate to severe cases. This finding highlights Ecc-LVH as a significant predictor of adverse outcomes in AS.

Area of Science:

  • Cardiology
  • Echocardiography
  • Clinical Outcomes

Background:

  • Aortic stenosis (AS) is a common valvular heart disease.
  • Left ventricular hypertrophy (LVH) is a known complication of AS.
  • The prognostic impact of different LVH patterns, specifically eccentric hypertrophy (Ecc-LVH), in AS requires further clarification.

Purpose of the Study:

  • To investigate the association between Ecc-LVH and adverse clinical outcomes in patients with aortic stenosis.
  • To determine if Ecc-LVH predicts heart failure (HF) and all-cause mortality (ACM) in AS patients.

Main Methods:

  • Retrospective analysis of electronic medical records for AS patients with Doppler echocardiograms.
  • Patients were categorized into four groups based on LVH and relative wall thickness (RWT).
  • Multivariate Cox proportional analysis was used to identify predictors of HF and ACM.

Main Results:

  • Eccentric LVH (RWT<0.43 and LVH) was identified as a predictor for both HF and ACM in AS patients.
  • Patients with AS and Ecc-LVH exhibited significantly increased ACM across moderate and severe AS stages.
  • Ecc-LVH was also associated with a higher incidence of HF in moderate AS.

Conclusions:

  • Eccentric left ventricular hypertrophy is an independent predictor of worse outcomes in aortic stenosis.
  • AS patients with Ecc-LVH experience higher rates of all-cause mortality and heart failure compared to other LV geometric patterns.
  • These findings underscore the importance of recognizing Ecc-LVH in risk stratification and management of AS.
Abstract

Keywords:
Aortic stenosisEccentric hypertrophyHeart failureLeft ventricular geometry

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