A new classification of left ventricular geometric patterns was significantly associated with symptoms in severe aortic stenosis (P<.05), whereas the classic 4-pattern classification was not (P=.157).
Cross-Sectional (n=286)
Does a new classification of geometric ventricular patterns better associate with symptoms in patients with severe aortic stenosis compared to the classic classification?
A new echocardiographic classification of LV remodeling patterns incorporating end-diastolic volume index is better associated with symptoms in severe aortic stenosis than the classic classification.
p-value: p=<.05
BACKGROUND: In severe aortic stenosis, different left ventricle (LV) remodeling patterns as a response to pressure overload have distinct hemodynamic profiles, cardiac function, and outcomes. The most common classification considers LV relative wall thickness and LV mass index to create 4 different groups. A new classification including also end-diastolic volume index has been recently proposed. AIM: To describe the prevalence of the newly identified remodeling patterns in patients with severe aortic stenosis and to evaluate their clinical relevance according to symptoms. METHODS: We analyzed 286 consecutive patients with isolated severe aortic stenosis. Current guidelines were used for echocardiographic evaluation. Symptoms were defined as the presence of angina, syncope, or NYHA class III-IV. RESULTS: The mean age was 75 ± 9 years, 156 patients (54%) were men, while 158 (55%) were symptomatic. According to the new classification, the most frequent remodeling pattern was concentric hypertrophy (57.3%), followed by mixed (18.9%) and dilated hypertrophy (8.4%). There were no patients with eccentric remodeling; only 4 patients had a normalLV geometry. Symptomatic patients showed significantly more mixed hypertrophy (P < .05), while the difference regarding the prevalence of the other patterns was not statistically significant. When we analyzed the distribution of the classic 4 patterns stratified by the presence of symptoms, however, we did not find a significant difference (P = .157). CONCLUSIONS: The new classification had refined the description of different cardiac geometric phenotypes that develop as a response to pressure overload. It might be superior to the classic 4 patterns in terms of association with symptoms.
Nora et al. (Mon,) conducted a cross-sectional in Severe aortic stenosis (n=286). New classification of geometric ventricular patterns vs. Classic 4 patterns classification was evaluated on Association of remodeling patterns with symptoms (angina, syncope, or NYHA class III-IV) (p=<.05). A new classification of left ventricular geometric patterns was significantly associated with symptoms in severe aortic stenosis (P<.05), whereas the classic 4-pattern classification was not (P=.157).