Left Ventricular Remodeling and Function in Adult Aortic Stenosis

Abstract

The aim of this study was to analyze the left ventricular (LV) geometric changes occurring in chronic pressure overload due to valvular aortic stenosis (AS). Fifty-six adult patients (30 women, 26 men, mean age seventy-two +/- nine years, range forty-five to eighty-five years) with isolated AS (mean valve area by Doppler = 0.6 +/- 0.2 cm2) underwent a complete Doppler echocardiographic examination. According to the value of relative wall thickness (RWT = 2 x posterior wall thickness/LV end-diastolic diameter) and LV mass index (LVMI) in normal subjects (RWT < or = 0.44, LVMI < or = 125 gr/m2) AS patients were subdivided into four groups: Normal: no patients; Concentric Remodeling RWT > 0.44, LVMI < or = 125 gr/m2): 4 patients (7%); Concentric Hypertrophy (RWT > 0.44, LVMI > 125 gr/m2): 39 patients (70%); and Eccentric Hypertrophy (RWT < or = 0.44, LVMI > 125 gr/m2): 13 patients [23%]. Eccentric hypertrophy patients had, as compared with those with concentric hypertrophy, a larger left ventricle (61 +/- 6.5 mm vs 47.6 +/- 6 mm, P < or = 0.001), a smaller mean wall thickness (11.3 +/- 1.2 vs 14.7 +/- 1.7 mm, P < 0.001) and reduced LV fractional shortening (FS% = 22.9 +/- 11 vs 42.6 +/- 8.7%, P < 0.001). Furthermore, most patients (11/13) of the former group had heart failure due to LV systolic dysfunction, while only 16 of 39 patients of the latter group had heart failure and all but 2 had normal LV systolic function.(ABSTRACT TRUNCATED AT 250 WORDS)