Key result
Increased LV wall thickness in severe AS is linked to a ~54% higher AVR rate.
Why the study?
It was unclear whether increased left ventricular wall thickness is associated with worse clinical outcomes in severe aortic stenosis.
Does increased left ventricular wall thickness predict worse clinical outcomes in patients with severe aortic stenosis?
Cohort (n=290)
Does increased left ventricular wall thickness predict worse clinical outcomes in patients with severe aortic stenosis?
Increased left ventricular wall thickness serves as an independent prognostic factor for cardiovascular death and is associated with higher AVR rates in severe aortic stenosis.
Answers are grounded in this paper and cite their sources.
Increased LV wall thickness may flag higher AVR utilization in severe AS; leaves open independent prognostic value for mortality or intervention timing.
Background It is unclear whether increased left ventricular (LV) thickness is associated with worse clinical outcomes in severe aortic stenosis (AS). The aim of this study was to determine the effect of increased LV wall thickness (LVWT) on major clinical outcomes in patients with severe AS. Methods and results This study included 290 severe AS patients (mean age 69.4 ± 11.0 years; 136 females) between January 2008 and December 2018. For outcome assessment, the endpoint was defined as death from all causes, cardiovascular death, and the aortic valve replacement (AVR) surgery rate. During follow-up (48.7 ± 39.0 months), 157 patients had AVR, 43 patients died, and 28 patients died from cardiovascular causes. Patients with increased LVWT underwent AVR surgery much more than those without LVWT (60.0% vs. 39.0%, p < 0.001 ). Furthermore, in patients with increased LVWT, the all-cause and cardiovascular death rates were significantly lower in the AVR group than in the non-AVR group (8.8% vs. 27.3%, p < 0.001, 4.8%, vs. 21.0%, p < 0.001 ). Multivariate analysis revealed that increased LVWT, age, dyspnea, and AVR surgery were significantly correlated with cardiovascular death. Conclusions In patients with severe AS, increased LVWT was associated with a higher AVR surgery rate and an increased rate of cardiovascular death independent of other well-known prognostic variates. Thus, these findings suggest that increased LVWT might be used as a potential prognostic factor in severe AS patients.
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Park et al. (2021) conducted a cohort in severe aortic stenosis (n=290). Increased left ventricular wall thickness (LVWT) vs. Without increased LVWT was evaluated on Death from all causes, cardiovascular death, and the aortic valve replacement (AVR) surgery rate (p=<0.001). In patients with severe aortic stenosis, increased left ventricular wall thickness was associated with a higher aortic valve replacement surgery rate (60.0% vs. 39.0%, p<0.001).
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