title: Asymmetric septal hypertrophy - a marker of hypertension in aortic stenosis (a SEAS substudy).
abstract: BACKGROUND
  Some patients with aortic stenosis develop asymmetric septal hypertrophy (ASH) that may influence the surgical approach and is associated with higher perioperative morbidity. The aim of this analysis was to characterize further this subtype of aortic stenosis patients.
  
  
  METHODS
  Baseline data in 1719 patients with asymptomatic aortic stenosis, participating in the Simvastatin Ezetimibe in Aortic Stenosis study evaluating the effect of combined treatment with simvastatin and ezetimibe on progression of aortic stenosis was used. The study population was divided according to presence of ASH (interventricular septal/posterior wall thickness ratio >1.5). Left ventricular (LV) hypertrophy was considered present if LV mass index > or =104 g/m(2) in women and > or =116 g/m(2) in men.
  
  
  RESULTS
  ASH was present in 22% of patients and associated with higher LV mass index, total peripheral resistance and peak transaortic velocity and concomitant hypertension (all p<0.05). Thirty-four percent of patients with ASH had combined ASH and LV hypertrophy (asymmetric LV hypertrophy). These patients had higher systolic blood pressure, lower LV ejection fraction and larger left atrial diameter than patients with ASH only. In logistic regression analyses, hypertension was the most important predictor both for ASH (odds ratio, OR 1.38 [1.05-1.82]) and for asymmetric LV hypertrophy (OR 2.99 [1.71-5.25]), both p<0.05) independent of other covariates including severity of aortic stenosis.
  
  
  CONCLUSIONS
  Hypertension is the main clinic characteristic of ASH and asymmetric LV hypertrophy in patients with asymptomatic aortic stenosis independent of severity of aortic stenosis.
authors.affiliation: Department of Heart Disease, Haukeland University Hospital, Bergen, Norway. ntuseth@gmail.com
authors.forename: Nora
authors.initials: N
authors.lastname: Tuseth
authors.forename: Dana
authors.initials: D
authors.lastname: Cramariuc
authors.forename: Ashild E
authors.initials: AE
authors.lastname: Rieck
authors.forename: Kristian
authors.initials: K
authors.lastname: Wachtell
authors.forename: Eva
authors.initials: E
authors.lastname: Gerdts
mesh_terms: D001024:Aortic Valve Stenosis / Q000150:complications* / Q000503:physiopathology*; D001384:Azetidines; D015415:Biomarkers; D006332:Cardiomegaly / Q000150:complications; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications; D000069438:Ezetimibe; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000503:physiopathology; D008297:Male; D019821:Simvastatin
chemical_list: D001384:Azetidines; D015415:Biomarkers; D019821:Simvastatin; D000069438:Ezetimibe