Left Ventricular Hypertrophy Does Not Affect 1-Year Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement. 

 -  2019 
<br/><br/>Available online through MWHC library: 2008 - present 
<br/><br/> BACKGROUND: The association between pre-procedural LVH pattern and severity and clinical outcomes after TAVR is uncertain.  CONCLUSIONS: In a contemporary cohort of patients who underwent TAVR, pre-procedural LVH according to left ventricular mass index and relative wall thickness was not associated with adverse outcomes at 1-year follow-up. TAVR is likely to benefit patients with severe aortic stenosis regardless of the presence of LVH.  Copyright (c) 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.  METHODS: Patients (n = 31,199) across 422 sites who underwent TAVR from November 2011 through June 2016 as part of the Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapies) Registry linked with the Centers for Medicare and Medicaid Services database were evaluated by varying LVH patterns, according to sex-specific cutoffs for left ventricular mass index and relative wall thickness. The association between LVH pattern (concentric remodeling, concentric LVH, and eccentric LVH) and outcomes (rates of mortality, myocardial infarction [MI], stroke, new dialysis requirement) at 1-year follow-up were evaluated using multivariate hazard models.  OBJECTIVES: The aim of this study was to evaluate the association between pre-procedural left ventricular hypertrophy (LVH) patterns and clinical outcomes after transcatheter aortic valve replacement (TAVR).  RESULTS: There were no significant associations between concentric remodeling (death: adjusted hazard ratio [HR]: 1.03; 95% confidence interval [CI]: 0.93 to 1.15; MI: HR: 1.05; 95% CI: 0.76 to 1.46; stroke: HR: 1.11; 95% CI: 0.89 to 1.39; new dialysis: HR: 0.86; 95% CI: 0.64 to 1.15), concentric LVH (death: HR: 1.04; 95% CI: 0.95 to 1.15; MI: HR: 1.12; 95% CI: 0.82 to 1.52; stroke: HR: 1.14; 95% CI: 0.92 to 1.40; new dialysis: HR: 1.17; 95% CI: 0.90 to 1.52), or eccentric LVH (death: HR: 0.98; 95% CI: 0.87 to 1.10; MI: HR: 1.07; 95% CI: 0.71 to 1.63; stroke: HR: 1.01; 95% CI: 0.78 to 1.32; new dialysis: HR: 1.25; 95% CI: 0.92 to 1.70) and outcomes at 1 year compared with patients without LVH. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1936-8798 
<br/><br/><label>Standard No.: </label>10.1016/j.jcin.2018.11.013 [doi] S1936-8798(18)32302-1 [pii] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Aortic Valve Stenosis/su [Surgery]<br/>*Aortic Valve/su [Surgery]<br/>*Hypertrophy, Left Ventricular/pp [Physiopathology]<br/>*Transcatheter Aortic Valve Replacement<br/>*Ventricular Function, Left<br/>*Ventricular Remodeling<br/>Aged<br/>Aged, 80 and over<br/>Aortic Valve Stenosis/dg [Diagnostic Imaging]<br/>Aortic Valve Stenosis/mo [Mortality]<br/>Aortic Valve Stenosis/pp [Physiopathology]<br/>Aortic Valve/dg [Diagnostic Imaging]<br/>Aortic Valve/pp [Physiopathology]<br/>Databases, Factual<br/>Female<br/>Humans<br/>Hypertrophy, Left Ventricular/dg [Diagnostic Imaging]<br/>Hypertrophy, Left Ventricular/mo [Mortality]<br/>Male<br/>Myocardial Infarction/mo [Mortality]<br/>Recovery of Function<br/>Registries<br/>Risk Assessment<br/>Risk Factors<br/>Severity of Illness Index<br/>Sex Factors<br/>Stroke/mo [Mortality]<br/>Time Factors<br/>Transcatheter Aortic Valve Replacement/ae [Adverse Effects]<br/>Transcatheter Aortic Valve Replacement/mo [Mortality]<br/>Treatment Outcome<br/>United States/ep [Epidemiology]
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Heart & Vascular Institute
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article