| Left ventricular hypertrophy in aortic valve stenosis: preventive or promotive of systolic dysfunction and heart failure? | |
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MedLine Citation:
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PMID: 15860517 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Markku Kupari; Heikki Turto; Jyri Lommi |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2005-04-28 |
Journal Detail:
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Title: European heart journal Volume: 26 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2005 Sep |
Date Detail:
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Created Date: 2005-08-22 Completed Date: 2006-02-08 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 1790-6 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, 00029 Helsinki, Finland. markku.kupari@hus.fi |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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
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