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

Vien T. Truong, Wojciech Mazur, John Broderick, Gregory F. Egnaczyk, Dean J. Kereiakes, Ian J. Sarembock, Joseph K. Choo, Satya Shreenivas, Sherif F. Nagueh, Cheryl Bartone, Eugene S. Chung

Research output: Contribution to journalArticle

Abstract

Background: The aim of this study was to examine the relationship between baseline left ventricular (LV) geometry and outcomes after transcatheter aortic valve replacement (TAVR). Methods: 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. Results: Distribution of baseline LV geometry differed between male and female patients (χ2 = 16.83, P = .001) but not at 1 month (χ2 = 2.56, P = .47) or 1 year (χ2 = 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 (χ2[3] = 8.108, P = .044, log-rank test) and at 6.5 years (χ2[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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)1357-1362.e2
JournalJournal of the American Society of Echocardiography
Volume33
Issue number11
DOIs
StatePublished - Nov 2020

Keywords

  • Hospitalization
  • LV geometry
  • Mortality
  • TAVR

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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