PMID- 27199054
OWN - NLM
STAT- MEDLINE
DCOM- 20170606
LR  - 20220321
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 67
IP  - 20
DP  - 2016 May 24
TI  - Outcomes in Moderate Mixed Aortic Valve Disease: Is it Time for a Paradigm Shift?
PG  - 2321-2329
LID - S0735-1097(16)01695-8 [pii]
LID - 10.1016/j.jacc.2016.03.509 [doi]
AB  - BACKGROUND: A direct comparison of outcomes between moderate mixed aortic valve 
      disease (MAVD) and isolated aortic stenosis (AS) or aortic regurgitation (AR) has 
      not been performed, making evidence-based recommendations difficult in patients 
      with MAVD. OBJECTIVES: This study sought to determine adverse event (AE) 
      occurrence (the primary endpoint), defined as New York Heart Association 
      functional class III/IV symptoms, aortic valve replacement, or cardiac death, and 
      to compare AE rates between MAVD and isolated AS or AR. METHODS: Asymptomatic 
      patients were identified with moderate MAVD and an ejection fraction >/=50% and 
      were followed at Mayo Clinic from 1994 to 2013. Moderate MAVD was defined as a 
      combination of moderate AS and moderate AR. Age- and sex-matched control groups 
      were selected with isolated moderate AR (n = 117), moderate AS (n = 117), 
      or severe AS (n = 117). RESULTS: At 9.1 +/- 4.2 years of follow-up, patients with 
      moderate MAVD (n = 251) had a mean age of 63 +/- 11 years, 73% were male, and 38% 
      had bicuspid valve. AE occurred in 193 (77%) patients in this group, including 
      symptom development (69%), aortic valve replacement (67%), and cardiac death 
      (4%). Predictors of AE were older age (hazard ratio [HR]: 1.71 per decade; 95% 
      confidence interval [CI]: 1.38 to 1.97 per decade; p = 0.001), and relative wall 
      thickness >0.42 (HR: 2.01; 95% CI: 1.86 to 2.33; p = 0.002). AE rates were 
      similar in the MAVD and severe AS group (71% vs. 68% at 5 years; p = 0.49), but 
      were significantly higher compared with the moderate AS and AR groups. 
      CONCLUSIONS: MAVD patients had outcomes comparable to those with severe AS, and 
      preserved ejection fraction and should be monitored closely for symptoms.
CI  - Copyright (c) 2016 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Egbe, Alexander C
AU  - Egbe AC
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
FAU - Luis, Sushil A
AU  - Luis SA
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
FAU - Padang, Ratnasari
AU  - Padang R
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
FAU - Warnes, Carole A
AU  - Warnes CA
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. 
      Electronic address: warnes.carole@mayo.edu.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2016 May 24;67(20):2330-2333. PMID: 27199055
CIN - J Am Coll Cardiol. 2016 Oct 25;68(17):1925-1926. PMID: 27765199
CIN - J Am Coll Cardiol. 2016 Oct 25;68(17):1926-1927. PMID: 27765201
MH  - Age Factors
MH  - Aortic Valve/diagnostic imaging
MH  - Aortic Valve Insufficiency/*mortality/*surgery
MH  - Aortic Valve Stenosis/*mortality/*surgery
MH  - Asymptomatic Diseases
MH  - Case-Control Studies
MH  - Death, Sudden
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/mortality
MH  - Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Stroke Volume
OTO - NOTNLM
OT  - adverse events
OT  - aortic regurgitation
OT  - aortic stenosis
OT  - aortic valve replacement
EDAT- 2016/05/21 06:00
MHDA- 2017/06/07 06:00
CRDT- 2016/05/21 06:00
PHST- 2015/12/27 00:00 [received]
PHST- 2016/03/08 00:00 [revised]
PHST- 2016/03/08 00:00 [accepted]
PHST- 2016/05/21 06:00 [entrez]
PHST- 2016/05/21 06:00 [pubmed]
PHST- 2017/06/07 06:00 [medline]
AID - S0735-1097(16)01695-8 [pii]
AID - 10.1016/j.jacc.2016.03.509 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2016 May 24;67(20):2321-2329. doi: 10.1016/j.jacc.2016.03.509.