Left ventricular septal hypertrophy in elderly patients with aortic stenosis

Minako Katayama, Prasad M. Panse, Christopher B. Kendall, John R. Daniels, Stephen S. Cha, F. David Fortuin, John P. Sweeney, Patrick A. DeValeria, Louis A. Lanza, Marek Belohlavek, Hari P Chaliki

Research output: Contribution to journalArticle

Abstract

Objectives—Left ventricular (LV) septal hypertrophy in aortic stenosis raises diagnostic and therapeutic questions. However, the etiology and clinical consequences of this finding have not been well studied. The aim of this study was to perform a morphologic evaluation of the LV in aortic stenosis and to investigate the contributing factors and consequences of septal hypertrophy. Methods—Patients with moderate or severe aortic stenosis were prospectively enrolled. Patients with previous myocardial infarction, wall motion abnormalities, at least moderate valvular regurgitation, known cardiomyopathy, an LV ejection fraction of less than 50%, and age younger than 65 years were excluded. Results—Forty-one patients underwent a final analysis. Septal hypertrophy (LV septal wall thickness ≥15mm) was confirmed in 21 of 41 patients. The septal hypertrophy group had higher peak aortic valve velocity, a higher diabetes mellitus rate, and a higher rate and longer duration of hypertension than those without septal hypertrophy. The peak aortic valve velocity (odds ratio, 7.1; 95% confidence interval, 1.4-37.1) and diabetes mellitus (odds ratio, 7.4; 95% confidence interval, 1.2-46.2) were the significant factors associated with septal hypertrophy by multivariate analysis. Intraventricular conduction disturbance on electrocardiography was more frequent in the septal hypertrophy group (P5.021). Conclusions—Left ventricular septal hypertrophy was commonly observed in elderly patients with aortic stenosis, and a higher aortic valve velocity, hypertension, and diabetes mellitus were associated factors. Intraventricular conduction disturbance occurred more often in patients with septal hypertrophy than those without, which implies the pathophysiologic consequence. Further studies are needed to determine the impact of septal hypertrophy and intraventricular conduction disturbance on the prognosis of patients after aortic valve interventions.

Original languageEnglish (US)
Pages (from-to)217-224
Number of pages8
JournalJournal of Ultrasound in Medicine
Volume37
Issue number1
DOIs
StatePublished - Jan 1 2017

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Aortic Valve Stenosis
Left Ventricular Hypertrophy
Hypertrophy
Aortic Valve
Diabetes Mellitus
Odds Ratio
Confidence Intervals
Hypertension
Cardiomyopathies
Electrocardiography
Multivariate Analysis
Myocardial Infarction

Keywords

  • Aortic stenosis
  • Echocardiography (adult)
  • Electrocardiology
  • Magnetic resonance imaging
  • Valvular heart disease

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

Katayama, M., Panse, P. M., Kendall, C. B., Daniels, J. R., Cha, S. S., Fortuin, F. D., ... Chaliki, H. P. (2017). Left ventricular septal hypertrophy in elderly patients with aortic stenosis. Journal of Ultrasound in Medicine, 37(1), 217-224. https://doi.org/10.1002/jum.14320

Left ventricular septal hypertrophy in elderly patients with aortic stenosis. / Katayama, Minako; Panse, Prasad M.; Kendall, Christopher B.; Daniels, John R.; Cha, Stephen S.; Fortuin, F. David; Sweeney, John P.; DeValeria, Patrick A.; Lanza, Louis A.; Belohlavek, Marek; Chaliki, Hari P.

In: Journal of Ultrasound in Medicine, Vol. 37, No. 1, 01.01.2017, p. 217-224.

Research output: Contribution to journalArticle

Katayama, M, Panse, PM, Kendall, CB, Daniels, JR, Cha, SS, Fortuin, FD, Sweeney, JP, DeValeria, PA, Lanza, LA, Belohlavek, M & Chaliki, HP 2017, 'Left ventricular septal hypertrophy in elderly patients with aortic stenosis', Journal of Ultrasound in Medicine, vol. 37, no. 1, pp. 217-224. https://doi.org/10.1002/jum.14320
Katayama M, Panse PM, Kendall CB, Daniels JR, Cha SS, Fortuin FD et al. Left ventricular septal hypertrophy in elderly patients with aortic stenosis. Journal of Ultrasound in Medicine. 2017 Jan 1;37(1):217-224. https://doi.org/10.1002/jum.14320
Katayama, Minako ; Panse, Prasad M. ; Kendall, Christopher B. ; Daniels, John R. ; Cha, Stephen S. ; Fortuin, F. David ; Sweeney, John P. ; DeValeria, Patrick A. ; Lanza, Louis A. ; Belohlavek, Marek ; Chaliki, Hari P. / Left ventricular septal hypertrophy in elderly patients with aortic stenosis. In: Journal of Ultrasound in Medicine. 2017 ; Vol. 37, No. 1. pp. 217-224.
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abstract = "Objectives—Left ventricular (LV) septal hypertrophy in aortic stenosis raises diagnostic and therapeutic questions. However, the etiology and clinical consequences of this finding have not been well studied. The aim of this study was to perform a morphologic evaluation of the LV in aortic stenosis and to investigate the contributing factors and consequences of septal hypertrophy. Methods—Patients with moderate or severe aortic stenosis were prospectively enrolled. Patients with previous myocardial infarction, wall motion abnormalities, at least moderate valvular regurgitation, known cardiomyopathy, an LV ejection fraction of less than 50{\%}, and age younger than 65 years were excluded. Results—Forty-one patients underwent a final analysis. Septal hypertrophy (LV septal wall thickness ≥15mm) was confirmed in 21 of 41 patients. The septal hypertrophy group had higher peak aortic valve velocity, a higher diabetes mellitus rate, and a higher rate and longer duration of hypertension than those without septal hypertrophy. The peak aortic valve velocity (odds ratio, 7.1; 95{\%} confidence interval, 1.4-37.1) and diabetes mellitus (odds ratio, 7.4; 95{\%} confidence interval, 1.2-46.2) were the significant factors associated with septal hypertrophy by multivariate analysis. Intraventricular conduction disturbance on electrocardiography was more frequent in the septal hypertrophy group (P5.021). Conclusions—Left ventricular septal hypertrophy was commonly observed in elderly patients with aortic stenosis, and a higher aortic valve velocity, hypertension, and diabetes mellitus were associated factors. Intraventricular conduction disturbance occurred more often in patients with septal hypertrophy than those without, which implies the pathophysiologic consequence. Further studies are needed to determine the impact of septal hypertrophy and intraventricular conduction disturbance on the prognosis of patients after aortic valve interventions.",
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author = "Minako Katayama and Panse, {Prasad M.} and Kendall, {Christopher B.} and Daniels, {John R.} and Cha, {Stephen S.} and Fortuin, {F. David} and Sweeney, {John P.} and DeValeria, {Patrick A.} and Lanza, {Louis A.} and Marek Belohlavek and Chaliki, {Hari P}",
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AU - Katayama, Minako

AU - Panse, Prasad M.

AU - Kendall, Christopher B.

AU - Daniels, John R.

AU - Cha, Stephen S.

AU - Fortuin, F. David

AU - Sweeney, John P.

AU - DeValeria, Patrick A.

AU - Lanza, Louis A.

AU - Belohlavek, Marek

AU - Chaliki, Hari P

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N2 - Objectives—Left ventricular (LV) septal hypertrophy in aortic stenosis raises diagnostic and therapeutic questions. However, the etiology and clinical consequences of this finding have not been well studied. The aim of this study was to perform a morphologic evaluation of the LV in aortic stenosis and to investigate the contributing factors and consequences of septal hypertrophy. Methods—Patients with moderate or severe aortic stenosis were prospectively enrolled. Patients with previous myocardial infarction, wall motion abnormalities, at least moderate valvular regurgitation, known cardiomyopathy, an LV ejection fraction of less than 50%, and age younger than 65 years were excluded. Results—Forty-one patients underwent a final analysis. Septal hypertrophy (LV septal wall thickness ≥15mm) was confirmed in 21 of 41 patients. The septal hypertrophy group had higher peak aortic valve velocity, a higher diabetes mellitus rate, and a higher rate and longer duration of hypertension than those without septal hypertrophy. The peak aortic valve velocity (odds ratio, 7.1; 95% confidence interval, 1.4-37.1) and diabetes mellitus (odds ratio, 7.4; 95% confidence interval, 1.2-46.2) were the significant factors associated with septal hypertrophy by multivariate analysis. Intraventricular conduction disturbance on electrocardiography was more frequent in the septal hypertrophy group (P5.021). Conclusions—Left ventricular septal hypertrophy was commonly observed in elderly patients with aortic stenosis, and a higher aortic valve velocity, hypertension, and diabetes mellitus were associated factors. Intraventricular conduction disturbance occurred more often in patients with septal hypertrophy than those without, which implies the pathophysiologic consequence. Further studies are needed to determine the impact of septal hypertrophy and intraventricular conduction disturbance on the prognosis of patients after aortic valve interventions.

AB - Objectives—Left ventricular (LV) septal hypertrophy in aortic stenosis raises diagnostic and therapeutic questions. However, the etiology and clinical consequences of this finding have not been well studied. The aim of this study was to perform a morphologic evaluation of the LV in aortic stenosis and to investigate the contributing factors and consequences of septal hypertrophy. Methods—Patients with moderate or severe aortic stenosis were prospectively enrolled. Patients with previous myocardial infarction, wall motion abnormalities, at least moderate valvular regurgitation, known cardiomyopathy, an LV ejection fraction of less than 50%, and age younger than 65 years were excluded. Results—Forty-one patients underwent a final analysis. Septal hypertrophy (LV septal wall thickness ≥15mm) was confirmed in 21 of 41 patients. The septal hypertrophy group had higher peak aortic valve velocity, a higher diabetes mellitus rate, and a higher rate and longer duration of hypertension than those without septal hypertrophy. The peak aortic valve velocity (odds ratio, 7.1; 95% confidence interval, 1.4-37.1) and diabetes mellitus (odds ratio, 7.4; 95% confidence interval, 1.2-46.2) were the significant factors associated with septal hypertrophy by multivariate analysis. Intraventricular conduction disturbance on electrocardiography was more frequent in the septal hypertrophy group (P5.021). Conclusions—Left ventricular septal hypertrophy was commonly observed in elderly patients with aortic stenosis, and a higher aortic valve velocity, hypertension, and diabetes mellitus were associated factors. Intraventricular conduction disturbance occurred more often in patients with septal hypertrophy than those without, which implies the pathophysiologic consequence. Further studies are needed to determine the impact of septal hypertrophy and intraventricular conduction disturbance on the prognosis of patients after aortic valve interventions.

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KW - Echocardiography (adult)

KW - Electrocardiology

KW - Magnetic resonance imaging

KW - Valvular heart disease

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