Abstract 3150: Left Ventricular Structure in Different Types of Chronic Pressure-Overload
Background: Aortic valve stenosis (AS) and hypertension (HT) both lead to left ventricular (LV) hypertrophy as a consequence of chronic pressure overload, but differences in LV geometric adaptation have been suggested.
Methods: To study the influence of type of pressure overload on LV structure, we pooled baseline echocardiograms and clinical information from HT patients with electrocardiographic LV hypertrophy in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study and asymptomatic AS patients in the Simvastatin Ezetimibe in Aortic Stenosis (SEAS) study. Patients < 45 years, or with diabetes, known cardiovascular disease or > grade 1 aortic valve regurgitation were excluded. HT was defined as history of HT or clinic blood pressure >140/90 mmHg. The study population was divided according to type of pressure overload: From LIFE HT (n=265); from SEAS AS (n=761) or combined HT and AS (n=649). LV geometry was assessed from LV mass/height2.7 (LV hypertrophy if > 49.2 g/m2.7 in men and >46.7 g/m2.7 in women) and relative wall thickness (elevated if > 0.43) in combination.
Results: Age, blood pressure, body mass index and LV mass/height2.7 differed significantly between the groups (all p < 0.01). Degree of AS did not differ between AS and AS+HT groups. The HT groups had higher prevalence of LV hypertrophy (Table 1⇓) (p< 0.01). AS groups had higher prevalence of grade 1 aortic regurgitation (p< 0.01). In logistic regression analysis, concentric LV geometry was associated with AS [OR 7.83 (95% CI 4.73–12.97)], older age and lower wall stress and midwall shortening, while eccentric LV geometry was associated with HT [OR 1.92 (95% CI 1.12–3.29)] and higher body weight (all p < 0.01).
Conclusions: Comparing groups of patients with asymptomatic AS, HT or combined HT + AS, AS was associated with concentric LV geometry and presence of HT with eccentric LV geometry independent of other well-known covariates of LV geometry during chronic pressure overload.