The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Influence of Concentric Left Ventricular Remodeling on Early Mortality After Aortic Valve Replacement
Open accessAbstract
Background Severe left ventricular (LV) hypertrophy increases risk for adverse outcome after aortic valve replacement. Whether LV geometry influences mortality risk after aortic valve replacement is unclear. And, whether LV mass or relative wall thickness (RWT) better predicts risk for adverse postoperative outcomes is unknown. The purpose of this investigation was to examine the influence of LV geometry and LV hypertrophy on morbidity and in-hospital mortality after aortic valve replacement, and to determine whether LV mass or RWT had better prognostic ability.Methods Between January 1996 and June 2004, 5,083 patients underwent aortic valve replacement. Preoperative echocardiographic data was used to calculate LV mass and RWT. Left ventricular geometry was classified into one of four categories on the basis of LV mass indexed to body height and RWT: (1) concentric hypertrophy, (2) eccentric hypertrophy, (3) concentric remodeling, and (4) normal. Postoperative mortality and multisystem morbidities of patients with concentric geometries were compared to patients with nonconcentric geometries by propensity and logistic regression modeling. Also, prognostic ability of RWT and LV mass was compared.Results Nine hundred sixty-four patients with concentric geometry were propensity-matched to 964 patients with nonconcentric geometry. In-hospital mortality (38 [3.9%] versus 18 [1.9%]; p = 0.007), cardiac morbidity (33 [3.4%] versus 17 [1.8%]; p = 0.022), and prolonged intubation (85 [8.8%] versus 58 [6.0%]; p = 0.019) were higher in patients with concentric versus nonconcentric geometry. Increasing RWT, not LV mass, was associated with adverse outcomes.Conclusions Concentric geometries are associated with increased risk for in-hospital mortality after aortic valve replacement. Increased RWT is associated with adverse outcomes. Preoperative risk stratification should include assessments of LV hypertrophy and LV geometry.
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“In patients with calcific AS, LV concentric remodelling or hypertrophy has been linked to worse myocardial function and increased risk of cardiac events and mortality compared to patients with normal LV geometry or with LV eccentric hypertrophy120–122.”
From Calcific aortic stenosis (2016) · cites this paper as [122]
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Metadata
- Authors
- Duncan, A. I., Lowe, B. S., Garcia, M. J., Xu, M., Gillinov, A. M., Mihaljevic, T., & Koch, C. G.
- Affiliations
- Cleveland Clinic (US)
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- Duncan, Andra Ibrahim
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 2008-06
- Volume
- 85
- Issue
- 6
- Pages
- 2030-2039
- ISSN
- 0003-4975 (ISSN-L)
- OpenAlex
- W2155083218
- Cited by
- 120
- References
- 32
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 5 · 2023: 4 · 2022: 4 · 2021: 8 · 2020: 9 · 2019: 12 · 2018: 8 · 2017: 8 · 2016: 6 · 2015: 13 · 2014: 11 · 2013: 8 · 2012: 6
- FWCI
- 3.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Annals of Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Keywords
- aortic valve replacement, left ventricular remodeling, concentric hypertrophy, left ventricular hypertrophy, left ventricular mass, relative wall thickness, left ventricular geometry, in-hospital mortality, postoperative morbidity, prolonged intubation, preoperative risk stratification, prognosis
- MeSH terms
- Aged, Aortic Valve Stenosis, Cardiac Output, Low, Cause of Death, Echocardiography, Female, Humans, Male, Middle Aged, Myocardial Infarction, Postoperative Complications, Prognosis, Risk Factors, Hospital Mortality, Hypertrophy, Left Ventricular, Echocardiography, Doppler, Color, Heart Valve Prosthesis Implantation, Ventricular Remodeling
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