scholarly journals Sex differences in left ventricular remodeling in patients with severe aortic valve stenosis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J H Kuneman ◽  
G K Singh ◽  
S Milhorini Pio ◽  
K Hirasawa ◽  
N Ajmone Marsan ◽  
...  
Keyword(s):  
Sex Differences ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Left Ventricular ◽  
Concentric Hypertrophy ◽  
Lv Mass ◽  
Lv Remodeling ◽  
All Cause Mortality ◽  
Eccentric Hypertrophy ◽  
Lv Volumes

Abstract Background Women with severe aortic valve stenosis (AS) have better long-term outcomes after transcatheter aortic valve implantation (TAVI) but worse survival after surgical aortic valve replacement compared to men. Whether this is related to sex differences in left ventricular (LV) remodeling is unknown. Purpose To examine sex differences in LV remodeling and outcomes in patients with severe AS undergoing TAVI. Methods Patients with severe AS who underwent TAVI between 2007 and 2018 with a pre-procedural multidetector row computed tomography (MDCT) scan were included. LV volumes, mass and function were analyzed with MDCT. Patients were classified into 4 LV remodeling patterns based on LV mass index and LV mass-to-volume ratio: 1) normal geometry, 2) concentric remodeling, 3) concentric hypertrophy and 4) eccentric hypertrophy. The primary endpoint was all-cause mortality after TAVI. Results A total of 289 patients (age 80±6 years, 54% male) were included. Women showed smaller LV volumes and mass compared to men. Concentric hypertrophy (50%) was the most frequent pattern of LV remodeling followed by eccentric hypertrophy (33%), normal geometry (13%) and concentric remodeling (4%). Concentric remodeling was more frequently observed in men compared to women (91% vs. 9% respectively, p=0.011). However, no sex differences were observed in the remaining LV remodeling patterns (Figure 1). During a median follow-up of 3.8 (IQR 2.2–5.1) years after TAVI, 87 patients died. Women demonstrated better outcome after TAVI compared to men (log-rank χ2=4.29, p=0.038). The survival benefit of women over men was mainly present among patients with concentric hypertrophy (log-rank χ2=4.91, p=0.027, Figure 2). Conclusion LV concentric and eccentric hypertrophy are similarly observed in men and women with severe AS. Women demonstrated better outcome after TAVI as compared to men, particularly among those with LV concentric hypertrophy. However, the outcome benefit of females after TAVI seems not to be related to sex-differences in LV remodeling. FUNDunding Acknowledgement Type of funding sources: None. Distribution of sex in LV remodeling All-cause mortality after TAVI

Subclinical leaflet thrombosis after transcatheter aortic valve implantation: association to reverse left ventricular remodeling

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.H Kuneman ◽  
G.K Singh ◽  
N.C Hansson ◽  
S.H Poulsen ◽  
E.M Vollema ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Left Ventricular ◽  
Transcatheter Aortic Valve ◽  
Lv Mass ◽  
Lv Remodeling ◽  
Lv Volumes ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Background Hypo-attenuated leaflet thickening (HALT) of transcatheter aortic valves can be observed on multidetector computed tomography (MDCT) and is considered as an early marker of leaflet thrombosis. Preliminary data has suggested that HALT will prevent or delay reverse left ventricular (LV) remodeling after transcatheter aortic valve implantation (TAVI). Purpose The purpose of the present study was to assess the association of HALT to reverse LV remodeling after TAVI. Methods In this multicenter study, patients who underwent MDCT after TAVI were evaluated. The presence of HALT was assessed with MDCT. Transthoracic echocardiograms were performed to assess LV dimensions and function before and 12 months after TAVI; transcatheter valve hemodynamics were assessed immediately after TAVI and at 12 months follow-up. Results A total of 169 patients (mean age 81±7 years, 53% male) who underwent MDCT performed 35 days [IQR 32–52] after TAVI were analyzed. HALT was observed in 42 (33%) patients. Before TAVI, LV mass (LVM) and LV mass index (LVMi) did not differ between patients with or without HALT: 227±80 vs. 234±62 g (p=0.568) and 121±37 vs. 126±32 g/m2 (p=0.35), respectively. Also LV ejection fraction (LVEF) was comparable between groups, 51±10 vs. 50±12%, p=0.64. LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were lower in patients with HALT: 75 (67–115) vs. 99 (77–127) ml (p=0.030) and 39 (30–53) vs. 46 (33–65) ml (p=0.050), respectively. At 12 months follow-up, we found no differences in LVM or LVMi regression, decrease of LV volumes or transprosthetic gradients between groups (Figure 1). Conclusion Patients who presented with HALT had significantly lower LV volumes before TAVI. LV mass and volumes regressed significantly at 12 months after TAVI, however LV remodeling was not associated to the presence of HALT. Funding Acknowledgement Type of funding source: None

scholarly journals Sex-differences in left ventricular remodeling and mechanics after aortic valve surgery in patients with severe aortic valve disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
G K Singh ◽  
E M Vollema ◽  
E A Prihadi ◽  
M V Regeer ◽  
S H Ewe ◽  
...  
Keyword(s):  
Sex Differences ◽  
Aortic Valve ◽  
Ejection Fraction ◽  
Aortic Valve Disease ◽  
Valve Disease ◽  
Men And Women ◽  
Lv Mass ◽  
Lv Remodeling ◽  
Lv Ejection Fraction

Abstract Background Sex-differences in left ventricular (LV) remodeling in patients with aortic valve disease have been reported. However, sex-differences in LV remodeling and mechanics in response to aortic valve replacement (AVR) remained largely unexplored. Purpose The present study aimed to evaluate the sex-differences during the time course of LV remodeling and LV mechanics (by LV global longitudinal strain (GLS)) after aortic valve replacement. Methods Patients with severe aortic valve disease (aortic stenosis (AS) or aortic regurgitation (AR)) undergoing AVR with echocardiographic follow-up at 1,2, and/or 5 years were evaluated. LV mass index, LV ejection fraction, LV GLS and stroke volume (SV) were measured. Linear mixed models analyses were used to assess changes in LV mass index, LVEF, LV GLS and SV between time points. The models were corrected for age, LV end-diastolic diameter at baseline and time between echocardiograms. Results A total of 211 patients (61±14 years, 61% male) with severe aortic valve disease (AS 63% or AR 39%) were included. Before AVR, men had larger LV mass index and higher SV compared to women. Both men and women had a preserved LV ejection fraction (54±12 and 56±9, P=0.102, respectively), but moderately impaired LV GLS (14.6±4.1 and 16.1±4.1, P=0.009, respectively). After AVR, both groups showed LV mass regression, improvement in LV ejection fraction and LV GLS. LV mass index and SV remained higher in men. During follow-up women showed significantly better LV GLS compared to men (P=0.030, figure 1). Conclusion In men and women with severe aortic valve disease undergoing AVR, the time course of changes in LV mass regression, LV ejection fraction, LV GLS and SV are similar. During follow-up LV mass index remained larger in men and women showed significantly better LV GLS. FUNDunding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The department of Cardiology received unrestricted research grants from Abbott Vascular, Bayer, Bioventrix, Biotronik, Boston Scientific, Edwards Lifesciences, GE Healthcare and Medtronic. Victoria Delgado received speaker fees from Abbott Vascular, Edwards Lifesciences, GE Healthcare, MSD and Medtronic. Nina Ajmone Marsan received speakers fees from Abbott Vascular and GE healthcare. Jeroen J Bax received speaker fees from Abbott Vascular. The remaining authors have nothing to disclose.

P3632Prognostic impact of aortic valve stenosis in patients with acute myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Mizutani ◽  
T Kurita ◽  
S Kasuya ◽  
T Mori ◽  
H Ito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
All Cause Mortality

Abstract Background Aortic valve stenosis (AS) is associated with the presence and severity of coronary artery disease independently of clinical risk factors, which leads to increased cardiovascular mortality. However, the prevalence of AS and its prognostic value among patients with acute myocardial infarction (AMI) remain unknown. Purpose The purpose of this study was to investigate the prevalence and prognostic impact of AS in AMI patients. Methods We studied 2,803 AMI patients using data from Mie ACS registry, a prospective and multicenter registry. Patients were divided into subgroups according to the presence and severity of AS based on maximal aortic flow rate by Doppler echocardiography before hospital discharge: non-AS <2.0 m/s, 2.0 m/s≤mild AS <3.0 m/s, 3.0 m/s≤moderate AS <4.0m/s and severe AS≥4.0 m/s. The primary outcome was defined as 2-year all-cause mortality. Results AS was detected in 79 patients (2.8%) including 49 mild AS, 23 moderate AS and 6 severe AS. AS patients were significantly older (79.9±9.8 versus 68.3±12.6 years), and higher killip classification than non-AS patients (P<0.01, respectively). However, left ventricular ejection fraction, and prevalence of primary PCI was similar between the 2 groups. During the follow-up periods (median 725 days), 333 (11.9%) patients experienced all-cause death. AS patients demonstrated the higher all-cause mortality rate compared to that of non-AS patients during follow up (47.3% versus 11.3%, P<0.0001, chi square). Kaplan-Meier curves showed that the probability of all-cause mortality was significantly higher among AS patients than non-AS patients, and was highest among moderate and severe AS (See figure A and B). Cox regression analyses for all-cause mortality demonstrated that the severity of AS was the strongest and independent poor prognostic factor (HR 1.71, 95% CI 1.30–2.24, P<0.001, See table). Cox hazard regression analysis Hazard ratio 95% Confidential interval P-value Severity of aortic valve stenosis 1.71 1.30–2.24 <0.001 Killip classification 1.63 1.46–1.82 <0.001 Age 1.07 1.06–1.09 <0.001 Serum creatinine level 1.05 1.03–1.08 <0.001 Max CPK level 1.00 1.00–1.01 <0.001 Left ventricular ejection fraction 0.96 0.95–0.97 <0.001 Primary percutaneous coronary intervention 0.67 0.47–0.96 0.03 CPK suggests creatinine phosphokinase. All cause mortality Conclusions The presence of AS of any severity contributes to worsening of patients' prognosis following AMI independently of other known risk factors. Acknowledgement/Funding None

scholarly journals Echocardiographic left ventricular geometry profiles for prediction of stroke, coronary heart disease and all-cause mortality in the Chinese community: a rural cohort population study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tan Li ◽  
Guangxiao Li ◽  
Xiaofan Guo ◽  
Zhao Li ◽  
Yingxian Sun
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Left Ventricular Geometry ◽  
Geometric Patterns ◽  
Concentric Hypertrophy ◽  
All Cause Mortality ◽  
Eccentric Hypertrophy

Abstract Background The utility of echocardiographic left ventricular (LV) geometry in the prediction of stroke/coronary heart disease (CHD) and all-cause mortality is not well characterized. This study aimed to evaluate the overall and sex-specific prognostic value of different geometric patterns on the incidence of stroke/CHD and all-cause mortality in a Chinese population-based cohort. Methods We conducted a prospective study in the general population in Northeast China, and a total of 9940 participants aged ≥ 35 years underwent echocardiography for LV geometry and were successfully followed up for incident stroke/CHD and all-cause death. Cox proportional hazards models were utilized to estimate the association of baseline LV geometry with adverse outcomes. Results Over a median follow-up of 4.66 years, abnormal LV geometric patterns had increased crude incident rates of stroke/CHD and all-cause mortality compared with normal geometry in overall population and each sex group (all P < 0.05). Multivariable Cox analysis reported that LV concentric and eccentric hypertrophy were associated with incident stroke/CHD (concentric hypertrophy: hazard ratio (HR) = 1.39, 95% confidence interval (CI) = 1.04–1.86; eccentric hypertrophy: HR = 1.42, 95% CI = 1.11–1.82) and all-cause mortality (concentric hypertrophy: HR = 1.50, 95% CI = 1.07–2.12; eccentric hypertrophy: HR = 1.58, 95% CI = 1.19–2.10), and LV concentric remodeling was related to stroke/CHD incidence (HR = 1.42, 95% CI = 1.09–1.84) in total population compared to normal geometry after the adjustment for potential confounders. In men, a significant increase was observed from LV eccentric hypertrophy for incident stroke/CHD, whereas in women, LV concentric hypertrophy was associated with elevated incidence of both stroke/CHD and all-cause death, and eccentric hypertrophy was correlated with increased all-cause mortality (all P < 0.05). Conclusions Our prospective cohort supports that abnormal LV geometry by echocardiography has a prognostic significance for incident stroke/CHD and all-cause mortality, implying that early detection and intervention of LV structural remodeling in rural China are urgently needed to prevent adverse outcomes.

scholarly journals Sex differences in left ventricular remodelling, myocardial fibrosis and mortality after aortic valve replacement

Heart ◽  
2019 ◽  
Vol 105 (23) ◽  
pp. 1818-1824 ◽  
Author(s):  
Anvesha Singh ◽  
Tarique Al Musa ◽  
Thomas A Treibel ◽  
Vassiliou S Vassiliou ◽  
Gabriella Captur ◽  
...  
Keyword(s):  
Sex Differences ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Cardiovascular Mortality ◽  
Left Ventricular ◽  
Risk Scores ◽  
Ventricular Remodelling ◽  
Left Ventricular Remodelling ◽  
All Cause Mortality

ObjectivesTo investigate sex differences in left ventricular remodelling and outcome in patients undergoing surgical or transcatheter aortic valve replacement (SAVR/TAVR).MethodsIn this multicentre, observational, outcome study with imaging core-lab analysis, patients with severe aortic stenosis (AS) listed for intervention at one of six UK centres were prospectively recruited and underwent cardiovascular magnetic resonance imaging. The primary endpoint was all-cause mortality and secondary endpoint was cardiovascular mortality.Results674 patients (425 men, 249 women, age 75±14 years) were included: 399 SAVR, 275 TAVR. Women were older, had higher surgical risk scores and underwent TAVR more frequently (53% vs 33.6%, p<0.001). More men had bicuspid aortic valves (BAVs) (26.7% vs 14.9%, p<0.001) and demonstrated more advanced remodelling than women. During a median follow-up of 3.6 years, 145 (21.5%) patients died, with no significant sex difference in all-cause mortality (23.3% vs 20.5%, p=0.114), but higher cardiovascular mortality in women (13.7% vs 8.5%, p=0.012). There were no significant sex-related differences in outcome in the SAVR or TAVR subgroups, or after excluding those with BAV. Factors independently associated with all-cause mortality were age, left ventricular ejection fraction (LVEF), BAV (better) and myocardial fibrosis detected with late gadolinium enhancement (LGE) in men, and age, LVEF and LGE in women. Age and LGE were independently associated with cardiovascular mortality in both sexes.ConclusionsMen demonstrate more advanced remodelling in response to a similar severity of AS. The higher cardiovascular mortality observed in women following AVR is accounted for by women having less BAV and higher risk scores resulting in more TAVR. LGE is associated with a worse prognosis in both sexes.

scholarly journals Left ventricular remodelling in masters athletes

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Papatheodorou ◽  
A Merghani ◽  
A Bakalakos ◽  
R Hughes ◽  
C Torlasco ◽  
...  
Keyword(s):  
Female Athletes ◽  
Ventricular Remodeling ◽  
Left Ventricular ◽  
P Value ◽  
Specific Response ◽  
Male Athletes ◽  
Concentric Hypertrophy ◽  
Lv Mass ◽  
Masters Athletes ◽  
Eccentric Hypertrophy

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): I have received a research fellowship grant from the UK based charity Cardiac Risk in the Young Objectives We investigated the effect of long-term exercise and sex on left ventricular (LV) geometry in a large group of female and male masters athletes. Background Studies assessing LV geometry in masters athletes are scarce. Methods Different types of LV geometry were identified according to echocardiography-derived relative wall thickness (RWT) and left ventricular mass (LVM) values as per international guidelines. 4 groups were formed: normal (normal LVM/normal RWT), concentric hypertrophy (increased LVM/increased RWT), eccentric hypertrophy (increased LVM/normal RWT), and concentric remodeling (normal LVM/increased RWT). Results A total of 277 healthy, elite, caucasian endurance masters athletes (65% female; mean age54.8 ± 7.7 years) were assessed. The athletes were exercising for a mean 32 ± 11.7 years and have completed a median 70 competitions including a median 13 marathon-type competitions. Females exhibited lower absolute LVM (127.7 ± 30.31g vs 196.57 ± 45.0g, p &lt; 0.001), indexed LVM (76.8 ± 18.0 g/m2 vs. 103.6 ± 22.7 g/m2; p &lt; 0.001), RWT (0.36 ± 0.07 vs. 0.42 ± 0.08; p &lt; 0.001) and absolute LV end-diastolic dimension (LVEDD) (46.3 ± 4.1 mm vs 50.1 ± 5.11 mm, p &lt; 0.001) but greater indexed LVEDD (27.7 ± 2.7mm/m2 vs 26.5 ± 2.7 mm/m2, p &lt; 0.001) compared with male athletes. Most female athletes showed normal LV geometry (72% vs 38% in male athletes, P &lt; 0.001) and significantly less concentric remodeling (12% vs 35%, p &lt; 0.001) and concentric hypertrophy (5% vs 13%, p = 0.01) (table & figure). Conclusions A sex-specific response to chronic exercise is observed. Male masters athletes exhibit significantly more frequently abnormal LV geometry with concentric LV remodeling and/or concentric hypertrophy. Cohort characteristics Male masters athletes N = 97 Female masters athletes N = 180 P value Age (years) 55.0 ± 9.0 54.7 ± 6.9 0.68 Years of exercise 32.0 ± 12.8 33.3 ± 11.1 0.14 LV Mass (g) 127.7 ± 30.31 196.57 ± 45.0 &lt;0.001 LV Mass Indexed (g/m2) 76.8 ± 18.0 103.6 ± 22.7 &lt;0.001 LVEDD (mm) 46.3 ± 4.1 50.1 ± 5.11 &lt;0.001 LVEDD Indexed (mm/m2) 27.7 ± 2.7 26.5 ± 2.7 &lt;0.001 Normal Remodeling 36 (37) 130 (72) &lt;0.001 Eccentric Hypertrophy 14 (14) 18 (10) 0.27 Concentric Remodeling 34 (35) 23 (13) &lt;0.001 Concentric Hypertrophy 13 (13) 9 (5) 0.01 LV Left Ventricular, LVEDD: Left Ventricular End Diastolic Dimension Abstract Figure. Patterns of left ventricular remodeling

Impact of paravalvular leak on left ventricular remodeling and global longitudinal strain 1 year after transcatheter aortic valve replacement

2020 ◽  
Author(s):  
Polydoros N Kampaktsis ◽  
Pritha Subramayam ◽  
Ines Sherifi ◽  
Manolis Vavuranakis ◽  
Gerasimos Siasos ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Paravalvular Leak ◽  
Transcatheter Aortic Valve ◽  
Lv Mass ◽  
Lv Remodeling ◽  
Lv Ejection Fraction

Background: New mild or persistent moderate paravalvular leak (PVL) is a known predictor of poor outcomes after transcatheter aortic valve replacement (TAVR). Its impact on left ventricular (LV) remodeling and global longitudinal strain (GLS) has not been well studied. Materials & methods: We collected echocardiographic data in 99 TAVR patients. LV remodeling and GLS were compared between patients with and without PVL. Results: Patients without PVL (n = 84) had significant LV ejection fraction, wall thickness and LV mass improvement compared with patients with PVL (n = 15; p < 0.001 for all). Diastolic function worsened in patients with PVL. Baseline GLS improved significantly regardless of PVL (p = 0.016 and p = 0.01, respectively) and was not predictive of LV ejection fraction or LV mass improvement when analyzed in tertiles. Conclusion: PVL impedes reverse LV remodeling but not GLS improvement 1-year after TAVR. Baseline GLS was not a predictor of LV remodeling.

scholarly journals Sex-specific relationships between patterns of ventricular remodelling and clinical outcomes

2020 ◽  
Vol 21 (9) ◽  
pp. 983-990 ◽  
Author(s):  
Robert J H Miller ◽  
Yoko Mikami ◽  
Bobak Heydari ◽  
Stephen B Wilton ◽  
Matthew T James ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Clinical Outcomes ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Prognostic Information ◽  
Concentric Hypertrophy ◽  
All Cause Mortality ◽  
Eccentric Hypertrophy ◽  
Myocardial Remodelling

Abstract Aims Left ventricular hypertrophy (LVH) is the most common form of myocardial remodelling and predicts adverse outcomes in patients with coronary artery disease (CAD). However, sex-specific prevalence and prognostic significance of LVH patterns are poorly understood. We investigated the sex-specific influence of LVH pattern on clinical outcomes in patients undergoing cardiovascular magnetic resonance (CMR) and coronary angiography following adjustment for co-morbidities including CAD burden. Methods and results Patients undergoing CMR and coronary angiography between 2005 and 2013 were included. Volumetric measurements of left ventricular (LV) mass with classification of concentric vs. eccentric remodelling patterns were determined from CMR cine images. Multivariable Cox analysis was performed to assess independent associations with the primary outcome of all-cause mortality. In total, 3754 patients were studied (mean age 59.3 ± 13.1 years), including 1039 (27.7%) women. Women were more likely to have concentric remodelling (8.1% vs. 2.1%, P &lt; 0.001), less likely to have eccentric hypertrophy (15.1% vs. 26.8%, P &lt; 0.001) and had a similar prevalence of concentric hypertrophy (6.1 vs. 5.2%, P = 0.296) compared to men. At a median follow-up of 3.7 years, 315 (8.4%) patients died. Following adjustment including CAD burden, concentric hypertrophy was associated with increased all-cause mortality in women [adjusted hazard ratio (HR) 3.48, P &lt; 0.001] and men (adjusted HR 2.57, P &lt; 0.001). Eccentric hypertrophy was associated with all-cause mortality only in women (adjusted HR 1.78, P = 0.047). Conclusion Patterns of LV remodelling differ by sex and LVH and provides prognostic information in both men and women. Our findings support the presence of sex-specific factors influencing LV remodelling.

scholarly journals Long Term Effects of Surgical And Transcatheter Aortic Valve Replacement On FFRCT In Patients With Severe Aortic Valve Stenosis.

2021 ◽  
Author(s):  
Vincent Michiels ◽  
Daniele Andreini ◽  
Edoardo Conte ◽  
Kaoru Tanaka ◽  
Dries Belsack ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Left Ventricular Mass ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Left Ventricular ◽  
Ventricular Mass ◽  
Lv Mass

Abstract Background: the long-term variations of fractional flow reserve derived from coronary computed tomography (FFR CT ) after surgical (SAVR) or transcatheter (TAVR) aortic valve replacement in patients with severe aortic valve stenosis (AS) have not been investigated. Methods and Results: a total of 25 patients with isolated, severe AS underwent coronary computed tomography with 3-vessel FFR CT analysis (Heartflow Inc. - Redwood City, California, USA) and measurement of total coronary volume (V), left ventricular mass (M) and their ratio (V/M) before and 6 months after SAVR or TAVR. A significant increase in V/M due to a decrease in left ventricular mass 6 months after intervention was observed, whereas total coronary volume did not change (coronary volume pre: 2924,5 ± 867,9 mm 3 , coronary volume post: 2844,2 ± 792,8 mm 3 , P =0.158; LV mass pre: 151.7 ± 40.7 g, LV mass post: 127.3 ± 34.7 g, P <0.001; V/M pre: 19.5 ± 4.1 mm 3 /g, V/M post: 22.7 ± 4.28 mm 3 /g, P =0.002). FFR CT (expressed as area under the virtual pullback curve) remained constant. Conclusion: this proof-of-concept study showed that FFR CT was not subject to the confounding effect of left ventricular mass regression after SAVR or TAVR. Despite significant left ventricular remodeling at 6 months after AS treatment, FFR CT values remained constant. This means FFR CT can probably be used as a reliable test in AS patients but further studies are needed comparing the performance of the different invasive and non-invasive coronary physiological indices in this patient cohort.

scholarly journals Left ventricular geometric patterns in hypertensive Nigerians: a systematic review

2015 ◽  
Vol 1 (2) ◽  
pp. 84 ◽  
Author(s):  
Kamilu Karaye
Keyword(s):  
Ventricular Hypertrophy ◽  
English Language ◽  
Left Ventricular ◽  
Geometric Patterns ◽  
Concentric Hypertrophy ◽  
Cardiovascular Morbidity And Mortality ◽  
Lv Mass ◽  
Eccentric Hypertrophy ◽  
On Line ◽  
Antihypertensive Treatments

Introduction: Several studies on left ventricular hypertrophy (LVH) and LV geometric patterns in hypertensive subjects<br />have been carried out in Nigeria, but the results vary widely. The present article aims to systematically review published<br />studies carried out in Nigeria on the prevalence and pattern of LV geometry in hypertensive subjects as determined using<br />echocardiography.<br />Methods: Relevant English language papers published up to 15th November 2012 were searched for in Medline, African<br />Journals on Line, Google Scholar and several other websites, and enquiries were made from colleagues. Study quality was<br />assessed using a condensed version of the Downs and Black checklist. LVH was defined in most of the studies as LV mass<br />index (LVMI) &gt;96g/m2 in women and &gt;116g/m2 in men, or LVMI &gt;125g/m2 for both sexes.<br />Results: A total of 148 records were initially obtained after excluding duplicates, but 138 articles had to be excluded (126 for<br />lack of relevance; 12 abstracts for lack of full length articles) while data in the remaining 10 were extracted, further analysed<br />and discussed. Out of a total of 1722 persons in all the included studies, 621 (36.1%) subjects had LVH, while 496 (28.8%)<br />had concentric remodelling and the remaining 605 (35.1%) subjects had normal geometry. Of those with LVH, 321 (51.7%) of<br />them had eccentric hypertrophy while the remaining 300 (48.3%) had concentric hypertrophy.<br />Conclusion: The findings in the present study have important clinical implications in the choice of antihypertensive treatments<br />to control the blood pressure, induce regression of LVH and reduce overall cardiovascular morbidity and mortality, as<br />recommended in standard guidelines.

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