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Impact of preprocedural left ventricle hypertrophy and geometrical patterns on mortality following TAVR

American Heart Journal Dec 06, 2019

Rozenbaum Z, Finkelstein A, Zhitomirsky S, et al. - Given that left ventricle (LV) hypertrophy (LVH) had not been clearly linked with death after transcatheter aortic valve replacement (TAVR) as opposed to surgical aortic valve replacement, and therefore, to address this issue, researchers conducted a retrospective study with patients registered in the Israeli multicenter TAVR registry, with available preprocedural LV mass index (LVMI) data. Based on LVMI, patients were grouped as follows: Normal LVMI, mild, moderate and severe LVH. Mild LVH was considered as the reference group. Overall 1,559 patients, 46.5% males, were examined. The study sample had a mean age of 82.2 (± 6.8) years and mean LVMI of 121 (± 29) gr/m2. Findings revealed a protective influence of mild concentric LVH in patients with severe aortic stenosis undergoing TAVR. However, hypertrophy became maladaptive and an increased baseline LVMI, eccentric pattern especially, may be related to all-cause mortality in this group of patients. An independent link of eccentric LVH, vs concentric LVH, with a 33% increased risk for mortality was also revealed.
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