Titre :

Prognostic significance of left ventricular concentric remodelling in patients with aortic stenosis

Auteur(s) :

Debry, Nicolas [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 [RNMCD]
Institut Coeur Poumon [CHU Lille]
Marechaux, Sylvestre [Auteur]
Rusinaru, Dan [Auteur]
Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux
Peltier, Marcel [Auteur]
Messika-Zeitoun, David [Auteur]
Service de cardiologie
Menet, Aymeric [Auteur]
Université catholique de Lille [UCL]
Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux
Tribouilloy, Christophe [Auteur]
CHU Amiens-Picardie
Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 [MP3CV]

Titre de la revue :

Archives of cardiovascular diseases

Pagination :

26-34

Date de publication :

2017

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Background. - Four patterns of left ventricular (LV) geometry (normal, concentric remodelling, concentric hypertrophy and eccentric hypertrophy) have been described in aortic stenosis (AS). Although LV concentric remodelling ...
Lire la suite >Background. - Four patterns of left ventricular (LV) geometry (normal, concentric remodelling, concentric hypertrophy and eccentric hypertrophy) have been described in aortic stenosis (AS). Although LV concentric remodelling (LVCR), characterized by normal LV mass despite increased LV wall thickness, is frequently observed in AS, its prognostic implication has been not specifically studied. Aim. - We aimed to assess, using echocardiography, the prognostic implication of LVCR in asymptomatic or minimally symptomatic patients with AS. Methods. - Overall, 331 patients (mean age 73 +/- 13 years; 45% women) with AS (aortic valve area <= 1.3 cm(2)) and an ejection fraction > 50% were enrolled. The endpoints were mortality with conservative management and mortality with conservative and/or surgical management. Results. - Sixty-three (19%) patients died under conservative management (follow-up 29 1 months). The highest risk of mortality under conservative management compared with patients with normal LV geometry was observed for LVCR (adjusted hazard ratio [HR]: 3.53, 95% confidence interval [CI]: 1.19-10.46; P = 0.023), followed by concentric LVH (adjusted HR: 2.97, 95% CI: 1.02-8.60; P = 0.045). Aortic valve replacement was performed in 96 patients (29%) during the entire follow-up (37 +/- 1 months); 72 (22%) patients died. Only LVCR remained independently associated with an increased risk of mortality when surgical management during the entire follow-up was considered (adjusted HR: 2.93, 95% CI: 1.19-7.23; P = 0.020). Conclusions. - Among the patterns of LV geometry in AS, LVCR portends the worst outcome. Patients with LVCR and AS have a considerable increased risk of mortality, regardless of clinical management. (C) 2016 Elsevier Masson SAS. All rights reserved.Lire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Collections :

• Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (RNMCD) - U1011

Source :

Harvested from HAL

Date de dépôt :

2022-02-19T04:01:07Z