TY - JOUR
T1 - Transcatheter Aortic Valve Replacement and Left Ventricular Geometry
T2 - Survival and Gender Differences
AU - Truong, Vien T.
AU - Mazur, Wojciech
AU - Broderick, John
AU - Egnaczyk, Gregory F.
AU - Kereiakes, Dean J.
AU - Sarembock, Ian J.
AU - Choo, Joseph K.
AU - Shreenivas, Satya
AU - Nagueh, Sherif F.
AU - Bartone, Cheryl
AU - Chung, Eugene S.
N1 - Publisher Copyright:
© 2020 American Society of Echocardiography
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020/11
Y1 - 2020/11
N2 - Background: The aim of this study was to examine the relationship between baseline left ventricular (LV) geometry and outcomes after transcatheter aortic valve replacement (TAVR). Methods: Patients undergoing TAVR (n = 206) had baseline LV geometry classified as (1) concentric hypertrophy, (2) eccentric hypertrophy, (3) concentric remodeling, or (4) normal. Descriptive statistics, Kaplan-Meier time-to-event analysis, and Cox regression were performed. Results: Distribution of baseline LV geometry differed between male and female patients (χ2 = 16.83, P = .001) but not at 1 month (χ2 = 2.56, P = .47) or 1 year (χ2 = 5.68, P = .13). After TAVR, a majority of patients with concentric hypertrophy evolved to concentric remodeling. Survival differed across LV geometry groups at 1 year (χ2[3] = 8.108, P = .044, log-rank test) and at 6.5 years (χ2[3] = 9.023, P = .029, log-rank test). Compared with patients with concentric hypertrophy, patients with normal geometry (hazard ratio, 2.25; 95% CI, 1.12–4.54; P = .023) and concentric remodeling (hazard ratio, 1.89; 95% CI, 1.12–3.17; P = .016) had higher rates of all-cause mortality. Conclusions: Baseline concentric hypertrophy confers a survival advantage after TAVR. Although baseline patterns of LV geometry appear gender specific (with women demonstrating more concentric hypertrophy), this difference resolves after TAVR.
AB - Background: The aim of this study was to examine the relationship between baseline left ventricular (LV) geometry and outcomes after transcatheter aortic valve replacement (TAVR). Methods: Patients undergoing TAVR (n = 206) had baseline LV geometry classified as (1) concentric hypertrophy, (2) eccentric hypertrophy, (3) concentric remodeling, or (4) normal. Descriptive statistics, Kaplan-Meier time-to-event analysis, and Cox regression were performed. Results: Distribution of baseline LV geometry differed between male and female patients (χ2 = 16.83, P = .001) but not at 1 month (χ2 = 2.56, P = .47) or 1 year (χ2 = 5.68, P = .13). After TAVR, a majority of patients with concentric hypertrophy evolved to concentric remodeling. Survival differed across LV geometry groups at 1 year (χ2[3] = 8.108, P = .044, log-rank test) and at 6.5 years (χ2[3] = 9.023, P = .029, log-rank test). Compared with patients with concentric hypertrophy, patients with normal geometry (hazard ratio, 2.25; 95% CI, 1.12–4.54; P = .023) and concentric remodeling (hazard ratio, 1.89; 95% CI, 1.12–3.17; P = .016) had higher rates of all-cause mortality. Conclusions: Baseline concentric hypertrophy confers a survival advantage after TAVR. Although baseline patterns of LV geometry appear gender specific (with women demonstrating more concentric hypertrophy), this difference resolves after TAVR.
KW - Hospitalization
KW - LV geometry
KW - Mortality
KW - TAVR
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U2 - 10.1016/j.echo.2020.06.015
DO - 10.1016/j.echo.2020.06.015
M3 - Article
C2 - 32828622
AN - SCOPUS:85089653273
SN - 0894-7317
VL - 33
SP - 1357-1362.e2
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 11
ER -