当前位置： SCI文献检索 > Journal of the American Heart Association期刊下所有文献 > Prognostic Markers and Long-Term Outcomes After Aortic Valve Replacement in Patients With Chronic Aortic Regurgitation.

Prognostic Markers and Long-Term Outcomes After Aortic Valve Replacement in Patients With Chronic Aortic Regurgitation.

Abstract：

:Background The objectives of the present study were (1) to evaluate the echocardiographic prognostic factors associated with improved left ventricular (LV) systolic function after aortic valve replacement, and (2) to compare the long-term outcomes after aortic valve replacement in chronic aortic regurgitation (AR) patients with or without LV dysfunction. Methods and Results A total of 280 patients who underwent aortic valve replacement because of chronic aortic regurgitation were studied. Patients with reduced LV systolic function (LV ejection fraction [LVEF] <50%; group reduced LVEF [rEF]; N=80) were compared with those with preserved LV systolic function (LVEF ≥50%; group preserved LVEF; N=200). Postoperative clinical outcomes, overall survival, and freedom from cardiac death were compared. Postoperative echocardiographic examinations were reviewed, and changes in echocardiographic parameters were analyzed. The parameters related to LVEF improvement or normalization were evaluated, and risk factors affecting long-term survival were identified. Follow-up was complete in 100% of patients, with a median follow-up of 104.8 months. Overall and cardiac mortality-free survival rates at postoperative 10 years were 80.1% and 92.9% and 87.3% and 97.2% in groups rEF and preserved LVEF, respectively (P=0.036 and P=0.058, respectively). LVEF tended to decrease in the early postoperative period but improved thereafter in both groups. Preoperative early diastolic transmitral flow velocity/mitral annular tissue velocity ratio was a parameter of postoperative improvement or normalization of LVEF in all patients (area under the curve, 0.719; P=0.003) and in group rEF patients (area under the curve, 0.726; P=0.011) with a cutoff value of 12.73. Preoperative early diastolic transmitral flow velocity/mitral annular tissue velocity ratio also was the parameter of overall survival in all patients (hazard ratio [HR], 1.08; P=0.001) and in group rEF patients (HR, 1.08; P=0.005). Conclusions Long-term outcomes and survival after aortic valve replacement were related to preoperative LV function in patients with chronic aortic regurgitation. Preoperative early diastolic transmitral flow velocity/mitral annular tissue velocity ratio was correlated with the postoperative improvement or normalization of LVEF and long-term survival, especially in group rEF patients.

journal_name

J Am Heart Assoc

journal_title

Journal of the American Heart Association

authors

Kim MS,Kim JH,Joo HC,Lee S,Youn YN,Lee SH

doi

10.1161/JAHA.120.018292

subject

Has Abstract

pub_date

2020-12-15 00:00:00

pages

e018292

issue

issn

2047-9980

journal_volume

pub_type

杂志文章

在线工具

Prognostic Markers and Long-Term Outcomes After Aortic Valve Replacement in Patients With Chronic Aortic Regurgitation.