Impact of hypertension on ventricular remodeling in patients with aortic stenosis.

Abstract:

BACKGROUND:Left ventricular hypertrophy (LVH) is a marker of increased cardiovascular risk and is frequently associated with both arterial hypertension (AH) and aortic stenosis (AoS). Also, these two maladies may co-exit in a same patient. However, in these cases, it is not clear the impact of each one in LVH. OBJECTIVE:To evaluate LVH and ventricular geometry in patients with AS associated or not with arterial hypertension. METHODS:This was a retrospective, observational and transversal study, including 298 consecutive patients with echocardiographic diagnosis of AoS. LVH was defined as myocardial mass > 224 g for men and > 162 g for women. Patients were classified as having mild (peak gradient < 30 mmHg), moderate (between 30 and 50 mmHg) or severe (> 50 mmHg) AoS and separated into two subgroups: with and without hypertension. RESULTS:AH was associated with increased ventricular mass in all three levels of aortic stenosis (mild AS: 172 ± 45 g vs 223 ± 73 g, p < 0.0001 moderate AoS: 189 ± 77 g vs 245 ± 81 g, p = 0.0313 severe AoS: 200 ± 62 g vs 252 ± 88 g, p = 0.0372), and increased risk of LVH (OR = 2.1 CI95%:1.2-3.6 p = 0.012). Regarding to geometric remodeling, hypertensive patients with severe AS presented a significant increase in frequency of concentric hypertrophy, when compared with those without hypertension (p = 0.013). CONCLUSION:Hypertension is an additional factor of increased left ventricular mass in patients with AS. Also, hypertension was influential in ventricular geometry.

journal_name

Arq Bras Cardiol

authors

Hueb JC,Vicentini JT,Roscani MG,Fusco D,Mattos R,Zanatti SG,Okoshi K,Matsubara BB

doi

10.1590/s0066-782x2011005000081

subject

Has Abstract

pub_date

2011-09-01 00:00:00

pages

254-9

issue

3

eissn

0066-782X

issn

1678-4170

pii

S0066-782X2011005000081

journal_volume

97

pub_type

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