Aims: The goal of this study was to assess the prevalence of left ventricular( LV) hypertrophy in patients with aortic stenosis late(>6 months) after aortic va lve replacement and its impact on cardiac-related morbidity and mortality. Meth ods and results: In a single tertiary centre, echocardiographic data of LV muscl e mass were collected. Detailed information of medical history and angiographic data were gathered. Ninety-nine of 213 patients(46%) had LV hypertrophy late(m ean 5.8±5.4 years) after aortic valve replacement. LV hypertrophy was associate d with impaired exercise capacity, higher New York Heart Association dyspnoea cl ass, a tendency for more frequent chest pain expressed as higher Canadian Cardio vascular Society class, and more rehospitalizations. 24%of patients with normal LV mass vs. 39%of patients with LV hypertrophy reported cardiac-related morbi dity(p=0.04). In a multivariate logistic regression model, LV hypertrophy was an independent predictor of cardiac-related morbidity(odds ratio 2.31, 95%CI 1.0 8 to 5.41), after correction for gender, baseline ejection fraction, and coronar y artery disease and its risk factors. Thirty seven deaths occurred during a tot al of 1959 patient years of follow-up(mean follow-up 9.6 years). Age at aortic valve replacement(hazard ratio 1.85, 95%CI 1.39 to 2.47, for every 5 years inc rease in age), coexisting coronary artery disease at the time of surgery(hazard ratio 3.36, 95%CI 1.31 to 8.62), and smoking(hazard ratio 4.82, 95%CI 1.72 to 13.45) were independent predictors of overall mortality late after surgery, but not LV hypertrophy. Conclusions: In patients with aortic valve replacement for i solated aortic stenosis, LV hypertrophy late after surgery is associated with in creased morbidity.
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