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Introduction remodeling is defined as the changes produced in the geometry of the left ventricle after damage or overload of the myocardium. The most common classification only considers left ventricle relative wall thickness and mass index, but a new classification includes also end-diastolic volume index. Purpose to determine if the new patterns of ventricular remodeling had clinical relevance according to symptoms or cardiovacular outcomes. Methods patients with severe aortic stenosis (valve area <1cm2) between 2015 and 2018 were included, excluding other concomitant at least moderate valvular diseases. The patients were classified according to the indexed ventricular mass, relative parietal thickness and left ventricular volume. Cardiovascular mortality was analyzed as the primary endpoint. Results we recruited 234 patients with severe aortic stenosis (55% women, age 77 ± 9 years) with a BMI of 29 ± 5, of which 82% were hypertensive, 47% diabetic, 47% dyslipidemic and 19% smokers. 81% were symptomatic. The average time of follow-up was 280 ± 231 days. 1% had eccentric hypertrophy, 7% mixed hypertrophy, 3% dilated hypertrophy, 73% concentric hypertrophy, 15% concentric remodeling; no patient presented normal ventricle or physiological hypertrophy. Dyspnea was the predominant symptom 100% in eccentric, mixed and dilated hypertrophy; 72% in concentric hypertrophy and 85% in concentric remodeling (p = 0.05). Most patients with mixed hypertrophy had NYHA functional class> II: 0% vs 62% vs 37% vs 27% vs 37% (p = 0.008). The group with the highest cardiovascular mortality was mixed hypertrophy (0% vs 43% vs 0% vs 14% vs 11%, p = 0.04), also shown in the survival analysis (Log Rank = 0.009) (Graph 1). Conclusions in patients with severe aortic stenosis, the pattern of mixed hypertrophy was an adverse prognostic marker in our study, although prognostic role of these new remodeling patterns needs to be investigated in future prospective studies. Abstract P655 Figure. Graph 1.: Kaplan-Meier survival function

Funding Acknowledgements Type of funding sources: None. Background Sodium-glucose cotransporter 2 inhibitors (SGLT2i) can reduce cardiovascular events in type 2 diabetes mellitus (T2DM) patients, although the mechanisms underlying these benefits are not clearly understood. Purpose The aim of this study was to analyze the effects of SGLT2i on left ventricular remodelling and longitudinal strain. Methods Between November 2019 and April 2020 we included 52 patients ≥18 years of age with T2DM, HbA1c between 6.5% and 10.0%, and estimated glomerular filtration ≥45 ml/min/1.73 m2. Patients were classified into SGLT2i group and control group, according to prescribed treatment by their referring physician. Conventional and speckle tracking echocardiography were performed by blinded sonographers, at baseline and after 6 months of treatment. Results Among the 52 included patients (44% females, mean age 66.8 ± 8.6 years, mean HbA1c 7.40 ± 0.7%), 30 patients were prescribed SGLT2i and 22 patients were classified as control group. Mean change in indexed left ventricular mass (LVM) was -10.85 ± 3.31 g/m2 (p = 0.003) in the SGLT2i group, and +2.34 ± 4.13 g/m2 (p = 0.58) in the control group. Absolute value of Global Longitudinal Strain (GLS) increased by a mean of 1.29 ± 0.47 (p = 0.011) in the SGLT2i group, and 0.40 ± 0.62 (p = 0.34) in the control group. We did not find correlations between changes in LVM and GLS, and other variables like change in HbA1c. Conclusions In patients with T2DM, SGLT2i were associated with a significant reduction in indexed LVM and a significant increase in longitudinal strain measured by speckle tracking echocardiography, which may explain in part the clinical benefits found in clinical trials.