Left Ventricular Hypertrophy Does Not Affect 1-Year Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement
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). The association between pre-procedural LVH pattern and severity and clinical outcomes after TAVR is unce...
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| Veröffentlicht in: | JACC. Cardiovascular interventions 2019-02, Vol.12 (4), p.373-382 |
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| creator | Varshney, Anubodh S. Manandhar, Pratik Vemulapalli, Sreekanth Kirtane, Ajay J. Mathew, Verghese Shah, Binita Lowenstern, Angela Kosinski, Andrzej S. Kaneko, Tsuyoshi Thourani, Vinod H. Bhatt, Deepak L. |
| description | 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).
The association between pre-procedural LVH pattern and severity and clinical outcomes after TAVR is uncertain.
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.
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.
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.
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| doi_str_mv | 10.1016/j.jcin.2018.11.013 |
| format | Article |
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The association between pre-procedural LVH pattern and severity and clinical outcomes after TAVR is uncertain.
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.
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.
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.
[Display omitted]</description><identifier>ISSN: 1936-8798</identifier><identifier>EISSN: 1876-7605</identifier><identifier>DOI: 10.1016/j.jcin.2018.11.013</identifier><identifier>PMID: 30784643</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; aortic stenosis ; Aortic Valve - diagnostic imaging ; Aortic Valve - physiopathology ; Aortic Valve - surgery ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - mortality ; Aortic Valve Stenosis - physiopathology ; Aortic Valve Stenosis - surgery ; Databases, Factual ; Female ; Humans ; Hypertrophy, Left Ventricular - diagnostic imaging ; Hypertrophy, Left Ventricular - mortality ; Hypertrophy, Left Ventricular - physiopathology ; left ventricular hypertrophy ; Male ; Myocardial Infarction - mortality ; Recovery of Function ; Registries ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Sex Factors ; Stroke - mortality ; Time Factors ; Transcatheter Aortic Valve Replacement - adverse effects ; Transcatheter Aortic Valve Replacement - mortality ; transcatheter aortic valve replacement ; Treatment Outcome ; United States - epidemiology ; Ventricular Function, Left ; Ventricular Remodeling</subject><ispartof>JACC. Cardiovascular interventions, 2019-02, Vol.12 (4), p.373-382</ispartof><rights>2019 American College of Cardiology Foundation</rights><rights>Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-9622795ffaab734c2c92f35137f190adaab6dd68a2a87b2e5c8b0c6bc9ea81213</citedby><cites>FETCH-LOGICAL-c400t-9622795ffaab734c2c92f35137f190adaab6dd68a2a87b2e5c8b0c6bc9ea81213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1936879818323021$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30784643$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Varshney, Anubodh S.</creatorcontrib><creatorcontrib>Manandhar, Pratik</creatorcontrib><creatorcontrib>Vemulapalli, Sreekanth</creatorcontrib><creatorcontrib>Kirtane, Ajay J.</creatorcontrib><creatorcontrib>Mathew, Verghese</creatorcontrib><creatorcontrib>Shah, Binita</creatorcontrib><creatorcontrib>Lowenstern, Angela</creatorcontrib><creatorcontrib>Kosinski, Andrzej S.</creatorcontrib><creatorcontrib>Kaneko, Tsuyoshi</creatorcontrib><creatorcontrib>Thourani, Vinod H.</creatorcontrib><creatorcontrib>Bhatt, Deepak L.</creatorcontrib><title>Left Ventricular Hypertrophy Does Not Affect 1-Year Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement</title><title>JACC. Cardiovascular interventions</title><addtitle>JACC Cardiovasc Interv</addtitle><description>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).
The association between pre-procedural LVH pattern and severity and clinical outcomes after TAVR is uncertain.
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.
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.
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.
[Display omitted]</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>aortic stenosis</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - physiopathology</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - mortality</subject><subject>Aortic Valve Stenosis - physiopathology</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertrophy, Left Ventricular - diagnostic imaging</subject><subject>Hypertrophy, Left Ventricular - mortality</subject><subject>Hypertrophy, Left Ventricular - physiopathology</subject><subject>left ventricular hypertrophy</subject><subject>Male</subject><subject>Myocardial Infarction - mortality</subject><subject>Recovery of Function</subject><subject>Registries</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Sex Factors</subject><subject>Stroke - mortality</subject><subject>Time Factors</subject><subject>Transcatheter Aortic Valve Replacement - adverse effects</subject><subject>Transcatheter Aortic Valve Replacement - mortality</subject><subject>transcatheter aortic valve replacement</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><subject>Ventricular Function, Left</subject><subject>Ventricular Remodeling</subject><issn>1936-8798</issn><issn>1876-7605</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtu1DAUhi0Eohd4ARbISzYJvmR8kdiMptAijShCbSVWluOctB4lcbCdSrPnQXgWngyPprBkdY6Ovv-XzofQG0pqSqh4v6t3zk81I1TVlNaE8mfolCopKinI6nnZNReVklqdoLOUdoQIoiV7iU44kaoRDT9FP7fQZ3wHU47eLYON-Go_Q8wxzA97fBEg4S8h43Xfg8uYVt-hIJvBT97ZAV8v2YWxMH7CX232pSbh26mDeB_8dI9vop2Ss_kBMkS8DjF79_vXnR0eAX-DebAOxpJ5hV70dkjw-mmeo9tPH282V9X2-vLzZr2tXENIrrRgTOpV31vbSt445jTr-Ypy2VNNbFfOouuEsswq2TJYOdUSJ1qnwSrKKD9H7469cww_FkjZjD45GAY7QViSYVQ1lCuhSUHZEXUxpBShN3P0o417Q4k52Dc7c7BvDvYNpabYL6G3T_1LO0L3L_JXdwE-HAEoXz56iCa5Is1B52Pxa7rg_9f_Bw2ymRc</recordid><startdate>20190225</startdate><enddate>20190225</enddate><creator>Varshney, Anubodh S.</creator><creator>Manandhar, Pratik</creator><creator>Vemulapalli, Sreekanth</creator><creator>Kirtane, Ajay J.</creator><creator>Mathew, Verghese</creator><creator>Shah, Binita</creator><creator>Lowenstern, Angela</creator><creator>Kosinski, Andrzej S.</creator><creator>Kaneko, Tsuyoshi</creator><creator>Thourani, Vinod H.</creator><creator>Bhatt, Deepak L.</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20190225</creationdate><title>Left Ventricular Hypertrophy Does Not Affect 1-Year Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement</title><author>Varshney, Anubodh S. ; Manandhar, Pratik ; Vemulapalli, Sreekanth ; Kirtane, Ajay J. ; Mathew, Verghese ; Shah, Binita ; Lowenstern, Angela ; Kosinski, Andrzej S. ; Kaneko, Tsuyoshi ; Thourani, Vinod H. ; Bhatt, Deepak L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-9622795ffaab734c2c92f35137f190adaab6dd68a2a87b2e5c8b0c6bc9ea81213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>aortic stenosis</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - physiopathology</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - mortality</topic><topic>Aortic Valve Stenosis - physiopathology</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertrophy, Left Ventricular - diagnostic imaging</topic><topic>Hypertrophy, Left Ventricular - mortality</topic><topic>Hypertrophy, Left Ventricular - physiopathology</topic><topic>left ventricular hypertrophy</topic><topic>Male</topic><topic>Myocardial Infarction - mortality</topic><topic>Recovery of Function</topic><topic>Registries</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Sex Factors</topic><topic>Stroke - mortality</topic><topic>Time Factors</topic><topic>Transcatheter Aortic Valve Replacement - adverse effects</topic><topic>Transcatheter Aortic Valve Replacement - mortality</topic><topic>transcatheter aortic valve replacement</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><topic>Ventricular Function, Left</topic><topic>Ventricular Remodeling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Varshney, Anubodh S.</creatorcontrib><creatorcontrib>Manandhar, Pratik</creatorcontrib><creatorcontrib>Vemulapalli, Sreekanth</creatorcontrib><creatorcontrib>Kirtane, Ajay J.</creatorcontrib><creatorcontrib>Mathew, Verghese</creatorcontrib><creatorcontrib>Shah, Binita</creatorcontrib><creatorcontrib>Lowenstern, Angela</creatorcontrib><creatorcontrib>Kosinski, Andrzej S.</creatorcontrib><creatorcontrib>Kaneko, Tsuyoshi</creatorcontrib><creatorcontrib>Thourani, Vinod H.</creatorcontrib><creatorcontrib>Bhatt, Deepak L.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>JACC. Cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Varshney, Anubodh S.</au><au>Manandhar, Pratik</au><au>Vemulapalli, Sreekanth</au><au>Kirtane, Ajay J.</au><au>Mathew, Verghese</au><au>Shah, Binita</au><au>Lowenstern, Angela</au><au>Kosinski, Andrzej S.</au><au>Kaneko, Tsuyoshi</au><au>Thourani, Vinod H.</au><au>Bhatt, Deepak L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Left Ventricular Hypertrophy Does Not Affect 1-Year Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement</atitle><jtitle>JACC. Cardiovascular interventions</jtitle><addtitle>JACC Cardiovasc Interv</addtitle><date>2019-02-25</date><risdate>2019</risdate><volume>12</volume><issue>4</issue><spage>373</spage><epage>382</epage><pages>373-382</pages><issn>1936-8798</issn><eissn>1876-7605</eissn><abstract>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).
The association between pre-procedural LVH pattern and severity and clinical outcomes after TAVR is uncertain.
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.
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.
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.
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30784643</pmid><doi>10.1016/j.jcin.2018.11.013</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1936-8798 |
| ispartof | JACC. Cardiovascular interventions, 2019-02, Vol.12 (4), p.373-382 |
| issn | 1936-8798 1876-7605 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Aged, 80 and over aortic stenosis Aortic Valve - diagnostic imaging Aortic Valve - physiopathology Aortic Valve - surgery Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - mortality Aortic Valve Stenosis - physiopathology Aortic Valve Stenosis - surgery Databases, Factual Female Humans Hypertrophy, Left Ventricular - diagnostic imaging Hypertrophy, Left Ventricular - mortality Hypertrophy, Left Ventricular - physiopathology left ventricular hypertrophy Male Myocardial Infarction - mortality Recovery of Function Registries Risk Assessment Risk Factors Severity of Illness Index Sex Factors Stroke - mortality Time Factors Transcatheter Aortic Valve Replacement - adverse effects Transcatheter Aortic Valve Replacement - mortality transcatheter aortic valve replacement Treatment Outcome United States - epidemiology Ventricular Function, Left Ventricular Remodeling |
| title | Left Ventricular Hypertrophy Does Not Affect 1-Year Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement |
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