Document Detail


Left ventricular hypertrophy in aortic valve stenosis: preventive or promotive of systolic dysfunction and heart failure?
MedLine Citation:
PMID:  15860517     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: In aortic stenosis (AS), left ventricular (LV) hypertrophy is considered a compensatory response helping maintain systolic function. Recent research in experimental AS suggests, however, that LV hypertrophy is not necessary to sustain LV contractions but may in fact be maladaptive. The present work aimed to clarify the role of LV hypertrophy in AS-related heart failure (HF) in man. METHODS AND RESULTS: We studied 137 adult patients with isolated AS undergoing pre-operative echocardiography and cardiac catheterization. HF was diagnosed by the European criteria and LV hypertrophy by sex-specific limits of echocardiographic LV mass. The higher the LV mass was, the poorer was the LV ejection fraction (beta=-0.26, P< 0.001, linear regression) and the greater the likelihood of HF independent of the severity of AS (P< 0.001, logistic regression). In the subgroup of critical AS (valve area <0.4 cm(2)/m(2), n=85), patients with absent LV hypertrophy (n=19) had better preserved ejection fraction (mean+/-SE, 64+/-3 vs. 57+/-2%, P=0.045) and less HF (16 vs. 48%, P=0.025) than patients with LV hypertrophy (n=66). CONCLUSION: In isolated AS, increased LV mass predicts the presence of systolic dysfunction and HF independent of the severity of valvular obstruction. LV hypertrophy may be maladaptive rather than beneficial in AS in man.
Authors:
Markku Kupari; Heikki Turto; Jyri Lommi
Related Documents :
16818457 - Utility of a new left ventricular asynchrony index as a predictor of reverse remodellin...
14529587 - Possible involvement of apoptotic death of myocytes in left ventricular remodeling afte...
14624427 - Delayed recovery of left ventricular function after recanalization of a chronic coronar...
2529757 - Influence of temporal smoothing on quantitation of left ventricular function by gated b...
21278397 - Adiponectin expression in patients with inflammatory cardiomyopathy indicates favourabl...
21371467 - Effects of des-aspartate-angiotensin i on myocardial ischemia-reperfusion injury in rats.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-04-28
Journal Detail:
Title:  European heart journal     Volume:  26     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-08-22     Completed Date:  2006-02-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1790-6     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, 00029 Helsinki, Finland. markku.kupari@hus.fi
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological
Adult
Aged
Aged, 80 and over
Aortic Valve Stenosis / complications*,  physiopathology,  surgery
Female
Heart Catheterization
Heart Failure / etiology*,  physiopathology,  ultrasonography
Hemodynamics
Humans
Hypertrophy, Left Ventricular / etiology*,  physiopathology
Male
Middle Aged
Postoperative Period
Stroke Volume
Comments/Corrections
Comment In:
Eur Heart J. 2005 Sep;26(17):1697-9   [PMID:  15911565 ]
Eur Heart J. 2005 Dec;26(24):2747   [PMID:  16246825 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease.
Next Document:  Use of granulocyte-colony stimulating factor during acute myocardial infarction to enhance bone marr...