Excessive ventricular hypertrophy, manifested as increased relative wall thickness, was associated with increased in-hospital mortality after aortic valve replacement (P=0.04).
Observational (n=54)
Does excessive left ventricular hypertrophy increase the risk of in-hospital mortality in patients undergoing aortic valve replacement for severe aortic stenosis?
Excessive left ventricular hypertrophy, indicated by increased relative wall thickness, is associated with higher in-hospital mortality after aortic valve replacement for severe aortic stenosis, particularly in women.
p-value: p=0.04
OBJECTIVES: We investigated the relation between the extent and pattern of left ventricular hypertrophy and surgical outcome in 54 patients undergoing aortic valve replacement for severe aortic stenosis. BACKGROUND: Previous work from our laboratory has demonstrated that a subgroup of patients, mostly elderly women with Doppler evidence of abnormal intracavitary flow acceleration, had an unexpectedly high in-hospital mortality rate after aortic valve replacement for aortic stenosis. We hypothesized that marked concentric hypertrophy, rather than the Doppler signal itself, was related to the poor outcome. METHODS: A retrospective analysis of the clinical, hemodynamic and echocardiographic data in patients who survived aortic valve replacement versus those who died in the hospital was performed. RESULTS: There were no differences between the 42 survivors and 12 nonsurvivors with regard to the clinical or hemodynamic variables. Of the echocardiographic variables analyzed, diastolic relative wall thickness was found to be significantly different between the two groups. Patients who died had significantly greater relative wall thickness (mean +/- SD) than those who survived (0.72 +/- 0.38 vs. 0.56 +/- 0.15, p = 0.04). Analysis by gender demonstrated that the relation between ventricular geometry and mortality held true only for women. CONCLUSIONS: We conclude that excessive ventricular hypertrophy, manifested as a markedly increased relative wall thickness, is associated with a significantly increased risk of postoperative mortality after aortic valve replacement for aortic stenosis.
Orsinell et al. (1993) conducted an observational in Severe aortic stenosis (n=54). Excessive ventricular hypertrophy (increased relative wall thickness) vs. Lower relative wall thickness was evaluated on In-hospital mortality (p=0.04). Excessive ventricular hypertrophy, manifested as increased relative wall thickness, was associated with increased in-hospital mortality after aortic valve replacement (P=0.04).