Your browser doesn't support javascript.
loading
Left Ventricular Hypertrophy and Biomarkers of Cardiac Damage and Stress in Aortic Stenosis.
Stein, Elliot J; Fearon, William F; Elmariah, Sammy; Kim, Juyong B; Kapadia, Samir; Kumbhani, Dharam J; Gillam, Linda; Whisenant, Brian; Quader, Nishath; Zajarias, Alan; Welt, Frederick G; Bavry, Anthony A; Coylewright, Megan; Piana, Robert N; Mallugari, Ravinder R; Clark, Daniel E; Patel, Jay N; Gonzales, Holly; Gupta, Deepak K; Vatterott, Anna; Jackson, Natalie; Huang, Shi; Lindman, Brian R.
Afiliación
  • Stein EJ; Department of Medicine Vanderbilt University Medical Center Nashville TN.
  • Fearon WF; Division of Cardiology Department of Medicine Stanford Medical Center Palo Alto CA.
  • Elmariah S; Division of Cardiology Department of Medicine Massachusetts General Hospital Boston MA.
  • Kim JB; Division of Cardiology Department of Medicine Stanford Medical Center Palo Alto CA.
  • Kapadia S; Division of Cardiology Department of Medicine Cleveland Clinic Foundation Cleveland OH.
  • Kumbhani DJ; Division of Cardiology Department of Medicine University of Texas Southwestern Medical Center Dallas TX.
  • Gillam L; Division of Cardiology Department of Medicine Morristown Medical Center Morristown NJ.
  • Whisenant B; Division of Cardiology Department of Medicine Intermountain Heart Institute Murray UT.
  • Quader N; Division of Cardiology Department of Medicine Barnes-Jewish Hospital St. Louis MO.
  • Zajarias A; Division of Cardiology Department of Medicine Barnes-Jewish Hospital St. Louis MO.
  • Welt FG; Division of Cardiology Department of Medicine University of Utah Hospital Salt Lake City UT.
  • Bavry AA; Division of Cardiology Department of Medicine University of Texas Southwestern Medical Center Dallas TX.
  • Coylewright M; Department of Cardiovascular Medicine The Erlanger Heart and Lung Institute Chattanooga TN.
  • Piana RN; Division of Cardiology Department of Medicine Vanderbilt University Medical Center Nashville TN.
  • Mallugari RR; Division of Cardiology Department of Medicine Vanderbilt University Medical Center Nashville TN.
  • Clark DE; Division of Cardiology Department of Medicine Vanderbilt University Medical Center Nashville TN.
  • Patel JN; Division of Cardiology Department of Medicine Vanderbilt University Medical Center Nashville TN.
  • Gonzales H; Division of Cardiology Department of Medicine Vanderbilt University Medical Center Nashville TN.
  • Gupta DK; Division of Cardiology Department of Medicine Vanderbilt University Medical Center Nashville TN.
  • Vatterott A; Division of Cardiology Department of Medicine Barnes-Jewish Hospital St. Louis MO.
  • Jackson N; Division of Cardiology Department of Medicine Vanderbilt University Medical Center Nashville TN.
  • Huang S; Structural Heart and Valve Center Vanderbilt University Medical Center Nashville TN.
  • Lindman BR; Department of Biostatistics Vanderbilt University School of Medicine Nashville TN.
J Am Heart Assoc ; 11(7): e023466, 2022 04 05.
Article en En | MEDLINE | ID: mdl-35301869
Background Left ventricular hypertrophy (LVH) is associated with increased mortality risk and rehospitalization after transcatheter aortic valve replacement among those with severe aortic stenosis. Whether cardiac troponin (cTnT) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) risk stratify patients with aortic stenosis and without LVH is unknown. Methods and Results In a multicenter prospective registry of 923 patients with severe aortic stenosis undergoing transcatheter aortic valve replacement, we included 674 with core-laboratory-measured LV mass index, cTnT, and NT-proBNP. LVH was defined by sex-specific guideline cut-offs and elevated biomarker levels were based on age and sex cut-offs. Adjusted Cox proportional hazards models evaluated associations between LVH and biomarkers and all-cause death out to 5 years. Elevated cTnT and NT-proBNP were present in 82% and 86% of patients with moderate/severe LVH, respectively, as compared with 66% and 69% of patients with no/mild LVH, respectively (P<0.001 for each). After adjustment, compared with no/mild LVH, moderate/severe LVH was associated with an increased hazard of mortality (adjusted hazard ratio [aHR], 1.34; 95% CI 1.01-1.77, P=0.043). cTnT and NT-proBNP each risk stratified patients with moderate/severe LVH (P<0.05). In a model with both biomarkers and LVH included, elevated cTnT (aHR, 2.08; 95% CI 1.45-3.00, P<0.001) and elevated NT-proBNP (aHR, 1.46; 95% CI 1.00-2.11, P=0.049) were each associated with increased mortality risk, whereas moderate/severe LVH was not (P=0.15). Conclusions Elevations in circulating cTnT and NT-proBNP are more common as LVH becomes more pronounced but are also observed in those with no/minimal LVH. As measures of maladaptive remodeling and cardiac injury, cTnT and NT-proBNP predict post-transcatheter aortic valve replacement mortality better than LV mass index. These findings may have important implications for risk stratification and treatment of patients with aortic stenosis.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Hipertrofia Ventricular Izquierda Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: J Am Heart Assoc Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Hipertrofia Ventricular Izquierda Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: J Am Heart Assoc Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido