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Long Term Clinical Outcomes in Patients with Moderate Aortic Stenosis
- Source :
- The Heart Surgery Forum. 23:E358-E365
- Publication Year :
- 2020
- Publisher :
- Carden Jennings Publishing Co., 2020.
-
Abstract
- Background: While the surgical correction of moderate aortic stenosis (AS) can be deferred with a watchful waiting according to the present guideline, the clinical outcomes for moderate AS with comorbidity have not extensively been studied. We aimed to explore the factors that would contribute to the outcomes of moderate AS with at least five years of follow-up duration. Methods: Medical records review identified patients with moderate aortic valve (AV) stenosis from January 2008 and December 2012. Echocardiographic data were gathered, and the final 5-year clinical outcomes, defined as the composite of cardiovascular (CV) death, admission for heart failure (HF) aggravation, and AV replacement, were evaluated. Results: Among 148 patients (mean age, 69.3 years; mean AV area, 1.24 cm2), 79 had adverse outcomes (16 CV deaths, 32 AV replacements, and 31 HF cases), during a mean follow-up of 5.6 years. The event group showed worse dyspnea of NYHA III-IV and a higher frequency of diabetes mellitus (DM). They had a higher frequency of moderate or moderate-to-severe functional mitral regurgitation (MR) and smaller AV area. In the multivariate analysis, DM (HR 2.29, 95% CI 1.03-5.10), moderate or moderate-to-severe MR (HR 4.84, 95% CI 1.66-10.07), and NYHA III-IV (HR 3.84, 95% CI 1.72-8.56) independently were associated with adverse outcomes. Conclusions: The symptomatic patients with moderate AS had higher events than expected, and early intervention should be considered in case of concomitant MR and DM.
- Subjects :
- Aortic valve
medicine.medical_specialty
business.industry
medicine.medical_treatment
Retrospective cohort study
General Medicine
medicine.disease
Comorbidity
Stenosis
medicine.anatomical_structure
Internal medicine
Concomitant
Heart failure
Severity of illness
medicine
Cardiology
Surgery
Cardiology and Cardiovascular Medicine
business
Watchful waiting
Subjects
Details
- ISSN :
- 15226662 and 10983511
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- The Heart Surgery Forum
- Accession number :
- edsair.doi...........dbcecf3bb0664e0c65a6acf548134d08