New classification of geometric patterns considering left ventricular volume in patients with chronic aortic valve regurgitation: Prevalence and association with adverse cardiovascular outcomes

Background Left ventricular (LV) remodeling due to aortic regurgitation (AR) often leads to maladaptive responses. We assessed the prevalence and clinical implications of LV remodeling considering LV volume, mass, and relative wall thickness at the time of AR diagnosis. Methods and Results Between 2...

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Bibliographic Details
Published in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2019-01, Vol.36 (1), p.38-46
Main Authors: Barbieri, Andrea, Giubertoni, Elisa, Bartolacelli, Ylenia, Bursi, Francesca, Manicardi, Marcella, Boriani, Giuseppe
Format: Article
Language:English
Subjects:
Aged
aortic regurgitation
aortic valve disease
Aortic Valve Insufficiency - complications
Aortic Valve Insufficiency - pathology
cardiovascular outcome
Chronic Disease
Echocardiography - methods
Female
Heart Failure - complications
Heart Ventricles - diagnostic imaging
Heart Ventricles - pathology
Humans
hypertrophy
left ventricular hypertrophy
left ventricular remodeling
Male
Organ Size
Patient Outcome Assessment
Prevalence
Retrospective Studies
Survival Analysis
Ventricular Remodeling
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Summary:Background Left ventricular (LV) remodeling due to aortic regurgitation (AR) often leads to maladaptive responses. We assessed the prevalence and clinical implications of LV remodeling considering LV volume, mass, and relative wall thickness at the time of AR diagnosis. Methods and Results Between 2008 and 2017, 370 consecutive patients (mean age 67.3 ± 16.1 years, 56.5% males), with moderate or severe AR, were retrospectively analyzed. LV geometric patterns and clinical outcomes (cardiovascular death, hospitalization for heart failure, or aortic valve replacement) were evaluated. LV dilatation (LV end‐diastolic volume >75 mL/m2) was present in 228 patients (61.6%). Applying the new LV remodeling classification system, 40 (10.8%) patients had normal geometry, 14 (3.8%) concentric remodeling, 43 (11.6%) concentric hypertrophy (LVH), 45 (12.2%) indeterminate LVH, 38 (10.3%) mixed LVH, 93 (25.1%) dilated LVH, 54 (14.6%) eccentric LVH, and 43 (11.6%) eccentric remodeling. During a median follow‐up of 3.48 years (25th–75th percentile 0.91–5.57), 97 (26.2%) had the combined endpoint. LV dilation (P 
ISSN:0742-2822
1540-8175
DOI:10.1111/echo.14190