Abstract
The aim of this study was to examine the relationship between baseline left ventricular (LV) geometry and outcomes after transcatheter aortic valve replacement (TAVR). Patients undergoing TAVR (n=206) had baseline LV geometry classified as (1) concentric hypertrophy, (2) eccentric hypertrophy, (3) concentric remodeling, or (4) normal. Descriptive statistics, Kaplan-Meier time-to-event analysis, and Cox regression were performed. Distribution of baseline LV geometry differed between male and female patients (χ2=16.83, P=.001) but not at 1month (χ2=2.56, P=.47) or 1year (χ2=5.68, P=.13). After TAVR, a majority of patients with concentric hypertrophy evolved to concentric remodeling. Survival differed across LV geometry groups at 1year (χ2[3]=8.108, P=.044, log-rank test) and at 6.5years (χ2[3]=9.023, P=.029, log-rank test). Compared with patients with concentric hypertrophy, patients with normal geometry (hazard ratio, 2.25; 95% CI, 1.12-4.54; P=.023) and concentric remodeling (hazard ratio, 1.89; 95% CI, 1.12-3.17; P=.016) had higher rates of all-cause mortality. Baseline concentric hypertrophy confers a survival advantage after TAVR. Although baseline patterns of LV geometry appear gender specific (with women demonstrating more concentric hypertrophy), this difference resolves after TAVR.
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