Prognostic effect of inappropriately high left ventricular mass in asymptomatic severe aortic stenosis
ObjectivesIn patients with aortic stenosis (AS) left ventricular (LV) myocardial growth may exceed individual needs to compensate LV haemodynamic load leading to inappropriately high LV mass (iLVM), a condition at high risk of adverse cardiovascular events. The prognostic impact of iLVM was determin...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2011-02, Vol.97 (4), p.301-307 |
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| creator | Cioffi, Giovanni Faggiano, Pompilio Vizzardi, Enrico Tarantini, Luigi Cramariuc, Dana Gerdts, Eva de Simone, Giovanni |
| description | ObjectivesIn patients with aortic stenosis (AS) left ventricular (LV) myocardial growth may exceed individual needs to compensate LV haemodynamic load leading to inappropriately high LV mass (iLVM), a condition at high risk of adverse cardiovascular events. The prognostic impact of iLVM was determined in 218 patients with asymptomatic severe AS.MethodsiLVM was recognised when the measured LV mass exceeded 10% of the expected value predicted from height, sex and stroke work (prognostic cut-off assessed by a specific ROC analysis). For assessment of outcome, the endpoint was defined as death from all causes, aortic valve replacement or hospital admission for non-fatal myocardial infarction and/or congestive heart failure.ResultsAt the end of follow-up (22+13 months) complete clinical data were available for 209 participants (mean age 75+11 years). A clinical event occurred in 81 of 121 patients (67%) with iLVM and in 26 of 88 patients (30%) with appropriate LV mass (aLVM) (p |
| doi_str_mv | 10.1136/hrt.2010.192997 |
| format | Article |
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The prognostic impact of iLVM was determined in 218 patients with asymptomatic severe AS.MethodsiLVM was recognised when the measured LV mass exceeded 10% of the expected value predicted from height, sex and stroke work (prognostic cut-off assessed by a specific ROC analysis). For assessment of outcome, the endpoint was defined as death from all causes, aortic valve replacement or hospital admission for non-fatal myocardial infarction and/or congestive heart failure.ResultsAt the end of follow-up (22+13 months) complete clinical data were available for 209 participants (mean age 75+11 years). A clinical event occurred in 81 of 121 patients (67%) with iLVM and in 26 of 88 patients (30%) with appropriate LV mass (aLVM) (p<0.001). Event-free survival in patients with aLVM and iLVM was 78% vs 56% at 1-year, 68% vs 29% at 3-year and 56% vs 10% at 5-year follow-up, respectively (all p<0.01). Cox analysis identified iLVM as a strong predictor of adverse outcome (Exp β 3.08; CI 1.65 to 5.73) independent of diabetes, transaortic valve peak gradient and extent of valvular calcification. Among patients with LV hypertrophy, those with iLVM had a risk of adverse events 4.5-fold higher than counterparts with aLVM.ConclusionsiLVM is common in patients with asymptomatic severe AS and is associated with an increased rate of cardiovascular events independent of other prognostic covariates.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/hrt.2010.192997</identifier><identifier>PMID: 20720251</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Aged ; Aortic stenosis ; aortic valve disease ; Aortic Valve Stenosis - mortality ; Aortic Valve Stenosis - pathology ; Biological and medical sciences ; Calcification ; Cardiology. Vascular system ; Cardiovascular disease ; Disease-Free Survival ; Echocardiography ; Endocardial and cardiac valvular diseases ; Female ; Gender ; Heart ; Heart attacks ; Heart Valve Prosthesis Implantation - statistics & numerical data ; Hospitalization - statistics & numerical data ; Humans ; Hypertension ; Hypertrophy, Left Ventricular - mortality ; Hypertrophy, Left Ventricular - pathology ; inappropriate left ventricular mass ; Laboratories ; left ventricular hypertrophy ; Male ; Medical imaging ; Medical sciences ; Mortality ; Myocardial Infarction - etiology ; old age ; Prognosis ; Stroke ; Studies ; Surgery ; Variance analysis</subject><ispartof>Heart (British Cardiac Society), 2011-02, Vol.97 (4), p.301-307</ispartof><rights>2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2011 (c) 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b493t-307eae407a1fd01c07ebaa872bb202b3da527cdfb797dd006fd46ff1702e102e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://heart.bmj.com/content/97/4/301.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://heart.bmj.com/content/97/4/301.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23550,27901,27902,77343,77374</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23795568$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20720251$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cioffi, Giovanni</creatorcontrib><creatorcontrib>Faggiano, Pompilio</creatorcontrib><creatorcontrib>Vizzardi, Enrico</creatorcontrib><creatorcontrib>Tarantini, Luigi</creatorcontrib><creatorcontrib>Cramariuc, Dana</creatorcontrib><creatorcontrib>Gerdts, Eva</creatorcontrib><creatorcontrib>de Simone, Giovanni</creatorcontrib><title>Prognostic effect of inappropriately high left ventricular mass in asymptomatic severe aortic stenosis</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>ObjectivesIn patients with aortic stenosis (AS) left ventricular (LV) myocardial growth may exceed individual needs to compensate LV haemodynamic load leading to inappropriately high LV mass (iLVM), a condition at high risk of adverse cardiovascular events. The prognostic impact of iLVM was determined in 218 patients with asymptomatic severe AS.MethodsiLVM was recognised when the measured LV mass exceeded 10% of the expected value predicted from height, sex and stroke work (prognostic cut-off assessed by a specific ROC analysis). For assessment of outcome, the endpoint was defined as death from all causes, aortic valve replacement or hospital admission for non-fatal myocardial infarction and/or congestive heart failure.ResultsAt the end of follow-up (22+13 months) complete clinical data were available for 209 participants (mean age 75+11 years). A clinical event occurred in 81 of 121 patients (67%) with iLVM and in 26 of 88 patients (30%) with appropriate LV mass (aLVM) (p<0.001). Event-free survival in patients with aLVM and iLVM was 78% vs 56% at 1-year, 68% vs 29% at 3-year and 56% vs 10% at 5-year follow-up, respectively (all p<0.01). Cox analysis identified iLVM as a strong predictor of adverse outcome (Exp β 3.08; CI 1.65 to 5.73) independent of diabetes, transaortic valve peak gradient and extent of valvular calcification. Among patients with LV hypertrophy, those with iLVM had a risk of adverse events 4.5-fold higher than counterparts with aLVM.ConclusionsiLVM is common in patients with asymptomatic severe AS and is associated with an increased rate of cardiovascular events independent of other prognostic covariates.</description><subject>Aged</subject><subject>Aortic stenosis</subject><subject>aortic valve disease</subject><subject>Aortic Valve Stenosis - mortality</subject><subject>Aortic Valve Stenosis - pathology</subject><subject>Biological and medical sciences</subject><subject>Calcification</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Disease-Free Survival</subject><subject>Echocardiography</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Female</subject><subject>Gender</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart Valve Prosthesis Implantation - statistics & numerical data</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertrophy, Left Ventricular - mortality</subject><subject>Hypertrophy, Left Ventricular - pathology</subject><subject>inappropriate left ventricular mass</subject><subject>Laboratories</subject><subject>left ventricular hypertrophy</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Mortality</subject><subject>Myocardial Infarction - etiology</subject><subject>old age</subject><subject>Prognosis</subject><subject>Stroke</subject><subject>Studies</subject><subject>Surgery</subject><subject>Variance analysis</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkduL1DAUxoMo7kWffZOAyILQ3VzapH1cxisuKnhh38Jpm-xkbJsxSRfnv_eMHVfwxYeQc5Lf-fg4HyFPODvnXKqLdczngu27RjSNvkeOeanqAp-u72Mtq6pQTOojcpLShjFWNrV6SI4E04KJih8T9ymGmymk7DtqnbNdpsFRP8F2G8M2esh22NG1v1nTwbpMb-2Uo-_mASIdISVEKaTduM1hhL1Isrc2Wgoh_u6yRXGfHpEHDoZkHx_uU_L19asvq7fF1cc371aXV0VbNjIXkmkLtmQauOsZ77BtAWot2hb9trKHSuiud61udN8zplxfKue4ZsJyPPKUnC266P7HbFM2o0-dHQaYbJiTqUstaim0RPLZP-QmzHFCc4brmmnOmWyQulioLoaUonUGdzJC3BnOzD4BgwmYfQJmSQAnnh5053a0_R3_Z-UIPD8AkDoYXISp8-kvJ3VTVapGrlg4j0v8efcP8btRWurKfPi2Mp_fM3UtsXiJ_IuFb8fNf13-AuqSrKg</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>Cioffi, Giovanni</creator><creator>Faggiano, Pompilio</creator><creator>Vizzardi, Enrico</creator><creator>Tarantini, Luigi</creator><creator>Cramariuc, Dana</creator><creator>Gerdts, Eva</creator><creator>de Simone, Giovanni</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20110201</creationdate><title>Prognostic effect of inappropriately high left ventricular mass in asymptomatic severe aortic stenosis</title><author>Cioffi, Giovanni ; Faggiano, Pompilio ; Vizzardi, Enrico ; Tarantini, Luigi ; Cramariuc, Dana ; Gerdts, Eva ; de Simone, Giovanni</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b493t-307eae407a1fd01c07ebaa872bb202b3da527cdfb797dd006fd46ff1702e102e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Aortic stenosis</topic><topic>aortic valve disease</topic><topic>Aortic Valve Stenosis - mortality</topic><topic>Aortic Valve Stenosis - pathology</topic><topic>Biological and medical sciences</topic><topic>Calcification</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>Disease-Free Survival</topic><topic>Echocardiography</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Female</topic><topic>Gender</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Heart Valve Prosthesis Implantation - statistics & numerical data</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertrophy, Left Ventricular - mortality</topic><topic>Hypertrophy, Left Ventricular - pathology</topic><topic>inappropriate left ventricular mass</topic><topic>Laboratories</topic><topic>left ventricular hypertrophy</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Mortality</topic><topic>Myocardial Infarction - etiology</topic><topic>old age</topic><topic>Prognosis</topic><topic>Stroke</topic><topic>Studies</topic><topic>Surgery</topic><topic>Variance analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cioffi, Giovanni</creatorcontrib><creatorcontrib>Faggiano, Pompilio</creatorcontrib><creatorcontrib>Vizzardi, Enrico</creatorcontrib><creatorcontrib>Tarantini, Luigi</creatorcontrib><creatorcontrib>Cramariuc, Dana</creatorcontrib><creatorcontrib>Gerdts, Eva</creatorcontrib><creatorcontrib>de Simone, Giovanni</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cioffi, Giovanni</au><au>Faggiano, Pompilio</au><au>Vizzardi, Enrico</au><au>Tarantini, Luigi</au><au>Cramariuc, Dana</au><au>Gerdts, Eva</au><au>de Simone, Giovanni</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic effect of inappropriately high left ventricular mass in asymptomatic severe aortic stenosis</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>97</volume><issue>4</issue><spage>301</spage><epage>307</epage><pages>301-307</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>ObjectivesIn patients with aortic stenosis (AS) left ventricular (LV) myocardial growth may exceed individual needs to compensate LV haemodynamic load leading to inappropriately high LV mass (iLVM), a condition at high risk of adverse cardiovascular events. The prognostic impact of iLVM was determined in 218 patients with asymptomatic severe AS.MethodsiLVM was recognised when the measured LV mass exceeded 10% of the expected value predicted from height, sex and stroke work (prognostic cut-off assessed by a specific ROC analysis). For assessment of outcome, the endpoint was defined as death from all causes, aortic valve replacement or hospital admission for non-fatal myocardial infarction and/or congestive heart failure.ResultsAt the end of follow-up (22+13 months) complete clinical data were available for 209 participants (mean age 75+11 years). A clinical event occurred in 81 of 121 patients (67%) with iLVM and in 26 of 88 patients (30%) with appropriate LV mass (aLVM) (p<0.001). Event-free survival in patients with aLVM and iLVM was 78% vs 56% at 1-year, 68% vs 29% at 3-year and 56% vs 10% at 5-year follow-up, respectively (all p<0.01). Cox analysis identified iLVM as a strong predictor of adverse outcome (Exp β 3.08; CI 1.65 to 5.73) independent of diabetes, transaortic valve peak gradient and extent of valvular calcification. Among patients with LV hypertrophy, those with iLVM had a risk of adverse events 4.5-fold higher than counterparts with aLVM.ConclusionsiLVM is common in patients with asymptomatic severe AS and is associated with an increased rate of cardiovascular events independent of other prognostic covariates.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>20720251</pmid><doi>10.1136/hrt.2010.192997</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Aortic stenosis aortic valve disease Aortic Valve Stenosis - mortality Aortic Valve Stenosis - pathology Biological and medical sciences Calcification Cardiology. Vascular system Cardiovascular disease Disease-Free Survival Echocardiography Endocardial and cardiac valvular diseases Female Gender Heart Heart attacks Heart Valve Prosthesis Implantation - statistics & numerical data Hospitalization - statistics & numerical data Humans Hypertension Hypertrophy, Left Ventricular - mortality Hypertrophy, Left Ventricular - pathology inappropriate left ventricular mass Laboratories left ventricular hypertrophy Male Medical imaging Medical sciences Mortality Myocardial Infarction - etiology old age Prognosis Stroke Studies Surgery Variance analysis |
| title | Prognostic effect of inappropriately high left ventricular mass in asymptomatic severe aortic stenosis |
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