Determinants of left ventricular hypertrophy in patients with aortic stenosis
Ernesto E. Salcedo, MDAddress reprint requests to E.E.S., Cleveland Clinic Foundation, Department of Cardiology, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Donna H. Korzick, MS
Philip J. Currie, MBBS
William J. Stewart, MD
Harry M. Lever, MD
Marlene Goormastic, MPH
The determinants of left ventricular (LV) mass were evaluated in 150 patients with aortic stenosis. All patients underwent M-mode, two-dimensional, and Doppler echocardiography. Peak aortic gradients ranged from 9 mmHg to 144 mmHg (mean 52.3 mmHg). The degree of left ventricular hypertrophy, as determined by LV mass index, was compared to several variables, including age, systolic blood pressure, left ventricular function, peak and mean pressure gradients, relative wall thickness, estimated LV systolic pressure, and aortic valve area. The LV mass index varied from 114.1 to 547.2 g/m2 (mean, 159.4 g/m2). Multiple regression analysis revealed that both age and LV function were highly significant predictors of LV mass index. Moreover, LV mass index and systolic blood pressure were significantly greater in patients older than 65 years (P<.01; P<.0001, respectively). These results suggest that the severity of left ventricular hypertrophy in the presence of aortic stenosis is multifactorial and not affected only by the hemodynamic severity of aortic stenosis as assessed by aortic valve area or pressure gradient estimation. Patient age, systolic blood pressure, and ventricular function should all be considered when evaluating the degree of left ventricular hypertrophy in patients with aortic stenosis.