PMID- 34966913
OWN - NLM
STAT- MEDLINE
DCOM- 20221121
LR  - 20221206
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Linking)
VI  - 23
IP  - 12
DP  - 2022 Nov 17
TI  - Left ventricular remodelling in bicuspid aortic valve disease.
PG  - 1669-1679
LID - 10.1093/ehjci/jeab284 [doi]
AB  - AIMS: Characterization of left ventricular (LV) geometric pattern and LV mass 
      could provide an important insight into the pathophysiological adaptations of the 
      LV to pressure and/or volume overload in patients with bicuspid aortic valve 
      (BAV) and significant (>/=moderate) aortic valve (AV) disease. This study aimed to 
      characterize LV remodelling and its prognostic impact in patients with BAV 
      according to the predominant type of valvular dysfunction. METHODS AND RESULTS: 
      In this international, multicentre BAV registry, 1345 patients [51.0 (37.0-63.0) 
      years, 71% male] with significant AV disease were identified. Patients were 
      classified as having isolated aortic stenosis (AS) (n = 669), isolated aortic 
      regurgitation (AR) (n = 499) or mixed aortic valve disease (MAVD) (n = 177). LV 
      hypertrophy was defined as a LV mass index >115 g/m2 in males and >95 g/m2 in 
      females. LV geometric pattern was classified as (i) normal geometry: no LV 
      hypertrophy, relative wall thickness (RWT) </=0.42, (ii) concentric remodelling: no 
      LV hypertrophy, RWT >0.42, (iii) concentric hypertrophy: LV hypertrophy, RWT 
      >0.42, and (iv) eccentric hypertrophy: LV hypertrophy, RWT </=0.42. Patients were 
      followed-up for the endpoints of event-free survival (defined as a composite of 
      AV repair/replacement and all-cause mortality) and all-cause mortality. Type of 
      AV dysfunction was related to significant variations in LV remodelling. Higher LV 
      mass index, i.e. LV hypertrophy, was independently associated with the composite 
      endpoint for patients with isolated AS [hazard ratio (HR) 1.08 per 25 g/m2, 95% 
      confidence interval (CI) 1.00-1.17, P = 0.046] and AR (HR 1.19 per 25 g/m2, 95% 
      CI 1.11-1.29, P < 0.001), but not for those with MAVD. The presence of concentric 
      remodelling, concentric hypertrophy and eccentric hypertrophy were independently 
      related to the composite endpoint in patients with isolated AS (HR 1.54, 95% CI 
      1.06-2.23, P = 0.024; HR 1.68, 95% CI 1.17-2.42, P = 0.005; HR 1.59, 95% CI 
      1.03-2.45, P = 0.038, respectively), while concentric hypertrophy and eccentric 
      hypertrophy were independently associated with the combined endpoint for those 
      with isolated AR (HR 2.49, 95% CI 1.35-4.60, P = 0.004 and HR 3.05, 95% CI 
      1.71-5.45, P < 0.001, respectively). There was no independent association 
      observed between LV remodelling and the combined endpoint for patients with MAVD. 
      CONCLUSIONS: LV hypertrophy or remodelling were independently associated with the 
      composite endpoint of AV repair/replacement and all-cause mortality for patients 
      with isolated AS and isolated AR, although not for patients with MAVD.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.
FAU - Butcher, Steele C
AU  - Butcher SC
AUID- ORCID: 0000-0001-8258-8802
AD  - Department of Cardiology, Leiden University Medical Center, Heart Lung Center, 
      Albinusdreef 2, 2300 RC Leiden, The Netherlands.
AD  - Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, 197 
      Wellington St, Perth WA 6000, Australia.
FAU - Pio, Stephan M
AU  - Pio SM
AUID- ORCID: 0000-0002-1868-3095
AD  - Department of Cardiology, Leiden University Medical Center, Heart Lung Center, 
      Albinusdreef 2, 2300 RC Leiden, The Netherlands.
FAU - Kong, William K F
AU  - Kong WKF
AUID- ORCID: 0000-0002-1589-9026
AD  - Department of Cardiology, Leiden University Medical Center, Heart Lung Center, 
      Albinusdreef 2, 2300 RC Leiden, The Netherlands.
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore.
FAU - Singh, Gurpreet K
AU  - Singh GK
AUID- ORCID: 0000-0002-4308-9872
AD  - Department of Cardiology, Leiden University Medical Center, Heart Lung Center, 
      Albinusdreef 2, 2300 RC Leiden, The Netherlands.
FAU - Ng, Arnold C T
AU  - Ng ACT
AUID- ORCID: 0000-0002-1925-9958
AD  - Department of Cardiology, Princess Alexandra Hospital, The University of 
      Queensland, Brisbane, 199 Ipswich Rd, Woolloongabba QLD 4102, Australia.
FAU - Perry, Rebecca
AU  - Perry R
AD  - Department of Cardiovascular Medicine, Flinders Medical Centre, Flinders Dr, 
      Bedford Park SA 5042, Adelaide, Australia.
FAU - Sia, Ching-Hui
AU  - Sia CH
AUID- ORCID: 0000-0002-2764-2869
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore.
FAU - Poh, Kian Keong
AU  - Poh KK
AUID- ORCID: 0000-0003-3515-7924
AD  - Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, 
      Singapore 117597, Singapore.
FAU - Almeida, Ana G
AU  - Almeida AG
AD  - Cardiology Department, Santa Maria University Hospital (CHLN), CAML, CCUL, Lisbon 
      School of Medicine of the Universidade de Lisboa, Av. Prof. Egas Moniz MB, 
      1649-028 Lisboa, Portugal.
FAU - Gonzalez, Ariana
AU  - Gonzalez A
AD  - Department of Cardiology, Hospital Universitario Ramon y Cajal, M-607, 9, 100, 
      28034 Madrid, Spain.
FAU - Shen, Mylene
AU  - Shen M
AD  - Quebec Heart and Lung Institute, Laval University, 2725 Ch Ste-Foy, Quebec, QC 
      G1V 4G5, Canada.
FAU - Yeo, Tiong Cheng
AU  - Yeo TC
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore.
FAU - Shanks, Miriam
AU  - Shanks M
AD  - Division of Cardiology, University of Alberta, Mazankowski Alberta Heart 
      Institute, 11220 83 Ave NW, Edmonton, AB T6G 2B7, Canada.
FAU - Popescu, Bogdan A
AU  - Popescu BA
AUID- ORCID: 0000-0001-6122-8533
AD  - University of Medicine and Pharmacy 'Carol Davila'-Euroecolab, Institute of 
      Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bulevardul Eroii Sanitari 8, 
      Bucuresti 050474, Romania.
FAU - Galian Gay, Laura
AU  - Galian Gay L
AD  - Department of Cardiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall 
      d'Hebron, 119, 08035 Barcelona, Spain.
FAU - Fijalkowski, Marcin
AU  - Fijalkowski M
AD  - First Department of Cardiology, Medical University of Gdansk, Marii 
      Sklodowskiej-Curie 3a, 80-210 Gdansk, Poland.
FAU - Liang, Michael
AU  - Liang M
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore.
AD  - Department of Cardiology, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 
      768828, Singapore.
FAU - Tay, Edgar
AU  - Tay E
AD  - Department of Cardiology, Princess Alexandra Hospital, The University of 
      Queensland, Brisbane, 199 Ipswich Rd, Woolloongabba QLD 4102, Australia.
FAU - Ajmone Marsan, Nina
AU  - Ajmone Marsan N
AUID- ORCID: 0000-0001-7208-5769
AD  - Department of Cardiology, Leiden University Medical Center, Heart Lung Center, 
      Albinusdreef 2, 2300 RC Leiden, The Netherlands.
FAU - Selvanayagam, Joseph
AU  - Selvanayagam J
AD  - Department of Cardiovascular Medicine, Flinders Medical Centre, Flinders Dr, 
      Bedford Park SA 5042, Adelaide, Australia.
FAU - Pinto, Fausto
AU  - Pinto F
AD  - Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, 
      Singapore 117597, Singapore.
FAU - Zamorano, Jose L
AU  - Zamorano JL
AD  - Cardiology Department, Santa Maria University Hospital (CHLN), CAML, CCUL, Lisbon 
      School of Medicine of the Universidade de Lisboa, Av. Prof. Egas Moniz MB, 
      1649-028 Lisboa, Portugal.
FAU - Pibarot, Philippe
AU  - Pibarot P
AUID- ORCID: 0000-0002-3607-279X
AD  - Department of Cardiology, Hospital Universitario Ramon y Cajal, M-607, 9, 100, 
      28034 Madrid, Spain.
FAU - Evangelista, Arturo
AU  - Evangelista A
AD  - University of Medicine and Pharmacy 'Carol Davila'-Euroecolab, Institute of 
      Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bulevardul Eroii Sanitari 8, 
      Bucuresti 050474, Romania.
FAU - Bax, Jeroen J
AU  - Bax JJ
AD  - Department of Cardiology, Leiden University Medical Center, Heart Lung Center, 
      Albinusdreef 2, 2300 RC Leiden, The Netherlands.
AD  - Heart Center, University of Turku and Turku University Hospital, Kiinamyllynkatu 
      4-8, 20521 Turku, Finland.
FAU - Delgado, Victoria
AU  - Delgado V
AUID- ORCID: 0000-0002-9841-2737
AD  - Department of Cardiology, Leiden University Medical Center, Heart Lung Center, 
      Albinusdreef 2, 2300 RC Leiden, The Netherlands.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
SB  - IM
MH  - Female
MH  - Humans
MH  - Male
MH  - Ventricular Remodeling/physiology
MH  - *Bicuspid Aortic Valve Disease
MH  - *Aortic Valve Stenosis
MH  - *Aortic Valve Insufficiency
MH  - Aortic Valve/diagnostic imaging
MH  - Hypertrophy, Left Ventricular/etiology
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - LV geometric pattern
OT  - LV mass index
OT  - LV remodelling
OT  - aortic regurgitation
OT  - aortic stenosis
OT  - bicuspid aortic valve
OT  - mixed aortic valve disease
COIS- Conflict of interest: The Department of Cardiology of the Leiden University 
      Medical Center received research grants from Abbott Vascular, Bioventrix, 
      Medtronic, Biotronik, Boston Scientific, GE Healthcare, and Edwards Lifesciences. 
      J.J.B. and N.A.M. received speaking fees from Abbott Vascular. V.D. received 
      speaker fees from Abbott Vascular, Medtronic, Edwards Lifesciences, and GE 
      Healthcare. The remaining authors have nothing to disclose.
EDAT- 2021/12/31 06:00
MHDA- 2022/11/22 06:00
CRDT- 2021/12/30 05:45
PHST- 2021/09/09 00:00 [received]
PHST- 2021/12/13 00:00 [accepted]
PHST- 2021/12/31 06:00 [pubmed]
PHST- 2022/11/22 06:00 [medline]
PHST- 2021/12/30 05:45 [entrez]
AID - 6489377 [pii]
AID - 10.1093/ehjci/jeab284 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2022 Nov 17;23(12):1669-1679. doi: 
      10.1093/ehjci/jeab284.