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Transcatheter Aortic Valve Replacement and Left Ventricular Geometry: Survival and Gender Differences.

Research paper by Vien T VT Truong, Wojciech W Mazur, John J Broderick, Gregory F GF Egnaczyk, Dean J DJ Kereiakes, Ian J IJ Sarembock, Joseph K JK Choo, Satya S Shreenivas, Sherif F SF Nagueh, Cheryl C Bartone, Eugene S ES Chung

Indexed on: 24 Aug '20Published on: 24 Aug '20Published in: Journal of The American Society of Echocardiography



Abstract

The aim of this study was to examine the relationship between baseline left ventricular (LV) geometry and outcomes after transcatheter aortic valve replacement (TAVR). Patients undergoing TAVR (n = 206) had baseline LV geometry classified as (1) concentric hypertrophy, (2) eccentric hypertrophy, (3) concentric remodeling, or (4) normal. Descriptive statistics, Kaplan-Meier time-to-event analysis, and Cox regression were performed. Distribution of baseline LV geometry differed between male and female patients (χ = 16.83, P = .001) but not at 1 month (χ = 2.56, P = .47) or 1 year (χ = 5.68, P = .13). After TAVR, a majority of patients with concentric hypertrophy evolved to concentric remodeling. Survival differed across LV geometry groups at 1 year (χ[3] = 8.108, P = .044, log-rank test) and at 6.5 years (χ[3] = 9.023, P = .029, log-rank test). Compared with patients with concentric hypertrophy, patients with normal geometry (hazard ratio, 2.25; 95% CI, 1.12-4.54; P = .023) and concentric remodeling (hazard ratio, 1.89; 95% CI, 1.12-3.17; P = .016) had higher rates of all-cause mortality. Baseline concentric hypertrophy confers a survival advantage after TAVR. Although baseline patterns of LV geometry appear gender specific (with women demonstrating more concentric hypertrophy), this difference resolves after TAVR. Copyright © 2020 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

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