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Left ventricular remodelling patterns in patients with moderate aortic stenosis
Jan Stassen1,2, See Hooi Ewe3, Kensuke Hirasawa1
1Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands.
European Heart Journal. Cardiovascular Imaging
|February 18, 2022
Summary
In moderate aortic stenosis (AS), concentric hypertrophy (CH) is linked to higher mortality. Assessing left ventricular (LV) remodelling patterns helps identify patients needing closer monitoring and potential early intervention for adverse events.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Echocardiography
Background:
- Moderate aortic stenosis (AS) poses risks, with outcomes influenced by left ventricular (LV) condition.
- LV remodelling assessment is crucial for risk stratification in moderate AS patients.
Purpose of the Study:
- To evaluate the association between different LV remodelling patterns and clinical outcomes in patients with moderate AS.
Main Methods:
- 1931 patients with moderate AS were classified into four LV remodelling groups: normal geometry (NG), concentric remodelling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH).
- Outcomes included all-cause mortality and a composite of mortality or aortic valve replacement (AVR).
Main Results:
- Patients with CH (36%) and EH (22%) had significantly higher 3-year mortality rates compared to NG (18%).
- Concentric hypertrophy (CH) was independently associated with increased mortality.
- Both CH and eccentric hypertrophy (EH) were associated with a composite endpoint of death or AVR.
Conclusions:
- Concentric hypertrophy (CH) in moderate AS patients indicates an elevated risk of all-cause mortality.
- Evaluating LV remodelling patterns can identify high-risk individuals for enhanced surveillance and timely intervention.
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