Severe, predominantly aortic stenosis without left ventricular hypertrophy (LVH) : effect of LVH definition
Seiler, C.; Ritter, M.; Widmer, V.; Jenni, R.
Schweizerische Medizinische Wochenschrift 125(11): 521-530
1995
ISSN/ISBN: 0036-7672 PMID: 7899845 Document Number: 445332
210 out of approximately 16,000 Doppler echocardiographic examinations between 1989 and 1992 at the University Hospital of Zurich, Switzerland, produced the diagnosis of severe, longstanding and predominant aortic stenosis with a mean transvalvular pressure gradient of > or = 50 mm Hg. These patients, who had no significant valvular heart disease other than aortic stenosis and no coronary artery disease, were investigated for the prevalence and for existing gender predominance of absent left ventricular hypertrophy (LVH) using eight different, clinically established and validated definitions for LVH. 4 to 44% of all study patients were found to have absent LVH depending on how LVH was defined. There was no gender predominance in patients without LVH if a gender-specific LVH definition was used. Defining absent LVH as LV mass index < 109 g/m2 body surface area (for women) and < 134 g/m2 body surface area (for men) combined with relative LV wall thickness < 0.45, the prevalence of absent LVH amounted to 4% (9/210 patients). The majority of patients had concentric LVH (132/210), 57/210 patients had excentric LVH, and 12/210 had concentric LV remodeling. There was a significant inverse association between the time elapsed since diagnosis of aortic stenosis and the finding of absent LVH. However, average duration since diagnosis of aortic stenosis in patients without LVH was quite long averaging 3.2 years. Therefore, factors other than duration of the disease and not investigated in this study seem to be more closely related to the absence of LVH.