Left Ventricular Septal Hypertrophy in Elderly Patients With Aortic Stenosis
| Autor: | Patrick A. DeValeria, Christopher B. Kendall, Stephen S. Cha, John R. Daniels, Marek Belohlavek, Louis A. Lanza, Hari P. Chaliki, F. David Fortuin, John P. Sweeney, Prasad M. Panse, Minako Katayama |
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| Rok vydání: | 2017 |
| Předmět: |
Aortic valve
medicine.medical_specialty Ejection fraction Radiological and Ultrasound Technology medicine.diagnostic_test business.industry valvular heart disease Cardiomyopathy 030204 cardiovascular system & hematology medicine.disease Surgery 03 medical and health sciences Stenosis 0302 clinical medicine medicine.anatomical_structure Internal medicine Aortic valve stenosis medicine Cardiology Radiology Nuclear Medicine and imaging cardiovascular diseases 030212 general & internal medicine Myocardial infarction business Electrocardiography |
| Zdroj: | Journal of Ultrasound in Medicine. 37:217-224 |
| ISSN: | 0278-4297 |
| DOI: | 10.1002/jum.14320 |
| Popis: | Objectives Left ventricular (LV) septal hypertrophy in aortic stenosis raises diagnostic and therapeutic questions. However, the etiology and clinical consequences of this finding have not been well studied. The aim of this study was to perform a morphologic evaluation of the LV in aortic stenosis and to investigate the contributing factors and consequences of septal hypertrophy. Methods Patients with moderate or severe aortic stenosis were prospectively enrolled. Patients with previous myocardial infarction, wall motion abnormalities, at least moderate valvular regurgitation, known cardiomyopathy, an LV ejection fraction of less than 50%, and age younger than 65 years were excluded. Results Forty-one patients underwent a final analysis. Septal hypertrophy (LV septal wall thickness ≥15 mm) was confirmed in 21 of 41 patients. The septal hypertrophy group had higher peak aortic valve velocity, a higher diabetes mellitus rate, and a higher rate and longer duration of hypertension than those without septal hypertrophy. The peak aortic valve velocity (odds ratio, 7.1; 95% confidence interval, 1.4–37.1) and diabetes mellitus (odds ratio, 7.4; 95% confidence interval, 1.2–46.2) were the significant factors associated with septal hypertrophy by multivariate analysis. Intraventricular conduction disturbance on electrocardiography was more frequent in the septal hypertrophy group (P = .021). Conclusions Left ventricular septal hypertrophy was commonly observed in elderly patients with aortic stenosis, and a higher aortic valve velocity, hypertension, and diabetes mellitus were associated factors. Intraventricular conduction disturbance occurred more often in patients with septal hypertrophy than those without, which implies the pathophysiologic consequence. Further studies are needed to determine the impact of septal hypertrophy and intraventricular conduction disturbance on the prognosis of patients after aortic valve interventions. |
| Databáze: | OpenAIRE |
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