TY  - BOOK
AU  - Asch, Federico M
AU  - Weissman, Neil J
TI  - Left Ventricular Hypertrophy and Clinical Outcomes Over 5 Years After TAVR: An Analysis of the PARTNER Trials and Registries
SN  - 1936-8798
PY  - 2020///
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Aortic Valve/su [Surgery]
KW  - *Hypertrophy, Left Ventricular/pp [Physiopathology]
KW  - *Transcatheter Aortic Valve Replacement
KW  - *Ventricular Function, Left
KW  - *Ventricular Remodeling
KW  - Aged
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/dg [Diagnostic Imaging]
KW  - Aortic Valve Stenosis/mo [Mortality]
KW  - Aortic Valve Stenosis/pp [Physiopathology]
KW  - Aortic Valve/dg [Diagnostic Imaging]
KW  - Aortic Valve/pp [Physiopathology]
KW  - Clinical Trials as Topic
KW  - Female
KW  - Humans
KW  - Hypertrophy, Left Ventricular/dg [Diagnostic Imaging]
KW  - Hypertrophy, Left Ventricular/mo [Mortality]
KW  - Male
KW  - Patient Readmission
KW  - Postoperative Complications/mo [Mortality]
KW  - Postoperative Complications/th [Therapy]
KW  - Recovery of Function
KW  - Registries
KW  - Risk Assessment
KW  - Risk Factors
KW  - Severity of Illness Index
KW  - Time Factors
KW  - Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
KW  - Transcatheter Aortic Valve Replacement/mo [Mortality]
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N2  - BACKGROUND: Prior studies assessing the association between baseline LVH and outcomes after surgical or TAVR for aortic stenosis (AS) have yielded  conflicting results; CONCLUSIONS: Severe baseline LVH is associated with higher 5-year death and rehospitalization rates after TAVR. These findings may have implications  for the optimal timing of valve replacement and the potential role for medical therapy to slow or prevent LVH as AS progresses before valve replacement, but  further studies are needed. Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved; METHODS: Patients with severe symptomatic AS at intermediate or high risk in the PARTNER (Placement of Aortic Transcatheter Valve) 1, 2, and S3 trials  and registries who received TAVR and had baseline measurements for left ventricular mass index (LVMi) were analyzed. The presence and severity of LVH was  determined by LVMi using American Society of Echocardiography sex-specific cutoffs; OBJECTIVES: This study sought to evaluate the association between severity of left ventricular hypertrophy (LVH) before transcatheter aortic valve  replacement (TAVR) and outcomes out to 5 years; RESULTS: Among 4,280 patients, those with no (n = 1,325), mild (n = 777), moderate (n = 628), and severe (n = 1,550) LVH had 5-year rates of death of  32.8%, 37.3%, 37.2%, and 44.8%, respectively (p < 0.001), and 5-year rates of cardiovascular (CV) death or rehospitalization of 33.6%, 39.2%, 42.4%, and  49.2%, respectively (p < 0.001). After adjustment, severe LVH (compared with no LVH) was associated with increased all-cause death (adjusted hazard ratio:  1.16; 95% confidence interval: 1.00 to 1.34; p = 0.04) and CV death or rehospitalization (adjusted hazard ratio: 1.34; 95% confidence interval: 1.16 to  1.54; p < 0.001), but no increased hazard was observed for mild or moderate LVH. In spline analyses performed in males and females separately, there was a  consistent linear association between increased LVMi and an increased adjusted hazard of CV mortality or rehospitalization. A similar relationship was  observed for all-cause death in females, but not males
UR  - https://dx.doi.org/10.1016/j.jcin.2020.03.011
UR  - https://dx.doi.org/10.1016/j.jcin.2020.03.011
ER  -