title: Impact of hypertension on ventricular remodeling in patients with aortic stenosis.
abstract: BACKGROUND
  Left ventricular hypertrophy (LVH) is a marker of increased cardiovascular risk and is frequently associated with both arterial hypertension (AH) and aortic stenosis (AoS). Also, these two maladies may co-exit in a same patient. However, in these cases, it is not clear the impact of each one in LVH.
  
  
  OBJECTIVE
  To evaluate LVH and ventricular geometry in patients with AS associated or not with arterial hypertension.
  
  
  METHODS
  This was a retrospective, observational and transversal study, including 298 consecutive patients with echocardiographic diagnosis of AoS. LVH was defined as myocardial mass > 224 g for men and > 162 g for women. Patients were classified as having mild (peak gradient < 30 mmHg), moderate (between 30 and 50 mmHg) or severe (> 50 mmHg) AoS and separated into two subgroups: with and without hypertension.
  
  
  RESULTS
  AH was associated with increased ventricular mass in all three levels of aortic stenosis (mild AS: 172 ± 45 g vs 223 ± 73 g, p < 0.0001 moderate AoS: 189 ± 77 g vs 245 ± 81 g, p = 0.0313 severe AoS: 200 ± 62 g vs 252 ± 88 g, p = 0.0372), and increased risk of LVH (OR = 2.1 CI95%:1.2-3.6 p = 0.012). Regarding to geometric remodeling, hypertensive patients with severe AS presented a significant increase in frequency of concentric hypertrophy, when compared with those without hypertension (p = 0.013).
  
  
  CONCLUSIONS
  Hypertension is an additional factor of increased left ventricular mass in patients with AS. Also, hypertension was influential in ventricular geometry.
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina de Botucatu-Unesp, Botucatu, SP, Brasil. jchueb@cardiol.br
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Hueb
authors.forename: João T R
authors.initials: JT
authors.lastname: Vicentini
authors.forename: Meliza Goi
authors.initials: MG
authors.lastname: Roscani
authors.forename: Daniéliso
authors.initials: D
authors.lastname: Fusco
authors.forename: Ricaro
authors.initials: R
authors.lastname: Mattos
authors.forename: Silméia Garcia
authors.initials: SG
authors.lastname: Zanatti
authors.forename: Katashi
authors.initials: K
authors.lastname: Okoshi
authors.forename: Beatriz B
authors.initials: BB
authors.lastname: Matsubara
mesh_terms: D001024:Aortic Valve Stenosis / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D009929:Organ Size; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020257:Ventricular Remodeling / Q000502:physiology*