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Journal of Cardiovascular Magnetic Resonance

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Open Access 01-12-2012 | Research

Left ventricular remodeling and hypertrophy in patients with aortic stenosis: insights from cardiovascular magnetic resonance

Authors: Marc R Dweck, Sanjiv Joshi, Timothy Murigu, Ankur Gulati, Francisco Alpendurada, Andrew Jabbour, Alicia Maceira, Isabelle Roussin, David B Northridge, Philip J Kilner, Stuart A Cook, Nicholas A Boon, John Pepper, Raad H Mohiaddin, David E Newby, Dudley J Pennell, Sanjay K Prasad

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2012

Abstract

Background

Cardiovascular magnetic resonance (CMR) is the gold standard non-invasive method for determining left ventricular (LV) mass and volume but has not been used previously to characterise the LV remodeling response in aortic stenosis. We sought to investigate the degree and patterns of hypertrophy in aortic stenosis using CMR.

Methods

Patients with moderate or severe aortic stenosis, normal coronary arteries and no other significant valve lesions or cardiomyopathy were scanned by CMR with valve severity assessed by planimetry and velocity mapping. The extent and patterns of hypertrophy were investigated using measurements of the LV mass index, indexed LV volumes and the LV mass/volume ratio. Asymmetric forms of remodeling and hypertrophy were defined by a regional wall thickening ≥ 13 mm and >1.5-fold the thickness of the opposing myocardial segment.

Results

Ninety-one patients (61±21 years; 57 male) with aortic stenosis (aortic valve area 0.93±0.32cm2) were recruited. The severity of aortic stenosis was unrelated to the degree (r²=0.012, P=0.43) and pattern (P=0.22) of hypertrophy. By univariate analysis, only male sex demonstrated an association with LV mass index (P=0.02). Six patterns of LV adaption were observed: normal ventricular geometry (n=11), concentric remodeling (n=11), asymmetric remodeling (n=11), concentric hypertrophy (n=34), asymmetric hypertrophy (n=14) and LV decompensation (n=10). Asymmetric patterns displayed considerable overlap in appearances (wall thickness 17±2mm) with hypertrophic cardiomyopathy.

Conclusions

We have demonstrated that in patients with moderate and severe aortic stenosis, the pattern of LV adaption and degree of hypertrophy do not closely correlate with the severity of valve narrowing and that asymmetric patterns of wall thickening are common.

Trial registration

ClinicalTrials.gov Reference Number: NCT00930735

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Title: Left ventricular remodeling and hypertrophy in patients with aortic stenosis: insights from cardiovascular magnetic resonance
Authors: Marc R Dweck
Sanjiv Joshi
Timothy Murigu
Ankur Gulati
Francisco Alpendurada
Andrew Jabbour
Alicia Maceira
Isabelle Roussin
David B Northridge
Philip J Kilner
Stuart A Cook
Nicholas A Boon
John Pepper
Raad H Mohiaddin
David E Newby
Dudley J Pennell
Sanjay K Prasad
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Journal of Cardiovascular Magnetic Resonance / Issue 1/2012
Electronic ISSN: 1532-429X
DOI: https://doi.org/10.1186/1532-429X-14-50

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Left ventricular remodeling and hypertrophy in patients with aortic stenosis: insights from cardiovascular magnetic resonance

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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