PMID- 28655164
OWN - NLM
STAT- MEDLINE
DCOM- 20190218
LR  - 20200306
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Linking)
VI  - 19
IP  - 6
DP  - 2018 Jun 1
TI  - Role of diastolic function indices in the risk stratification of patients with 
      mixed aortic valve disease.
PG  - 668-674
LID - 10.1093/ehjci/jex148 [doi]
AB  - AIMS: Determine the role of diastolic function indices in pre-operative and 
      post-operative risk stratification in patients with moderate mixed aortic valve 
      disease (MAVD). METHODS AND RESULTS: A retrospective study was conducted of 
      asymptomatic patients with moderate MAVD (a combination of moderate aortic 
      stenosis and moderate aortic regurgitation) and an ejection fraction of 50% or 
      more who were followed up at Mayo Clinic from 1 January 2004, to 31 December 
      2013. A pre-requisite for inclusion in the study was assessment of diastolic 
      function involving at least three of the following indices: tissue Doppler early 
      diastolic velocity (e'), mitral inflow early velocity (E), tricuspid 
      regurgitation velocity, and left atrial volume index. Primary endpoints were 
      aortic valve replacement (AVR) or cardiac death while secondary endpoints were 
      cardiovascular adverse events (CAEs) after AVR. We defined CAEs as stroke, heart 
      failure hospitalization, severe left ventricular dysfunction, and cardiac death. 
      There were 214 patients (age 61 +/- 8 years, men 146 [68%]) followed for 
      6.1 +/- 2.3 years during which 162 (76%) AVRs and 11 (5%) cardiac deaths occurred. 
      The multivariable risk factors for cardiac death or AVR were relative wall 
      thickness (RWT) > 0.42 [hazard ratio (HR), 1.88 [95% CI, 1.28-2.59]; P = 0.001] 
      and average E/e' >14 (HR, 1.94 [95% CI, 1.29-3.01]; P = 0.02). Freedom from CAE 
      after AVR was significantly lower in the patients with baseline RWT >0.42 or mean 
      E/e' >14 than the other patients: 79% (95% CI 74-83%) vs. 94% (95% CI 89-98%) at 
      3 years (P = 0.03). CONCLUSION: The presence of RWT >0.42 or E/e' >14 identifies 
      a high-risk patient subset whose risk for cardiovascular morbidities persists 
      even after AVR.
FAU - Egbe, Alexander C
AU  - Egbe AC
AD  - Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 
      55905, USA.
FAU - Khan, Arooj R
AU  - Khan AR
AD  - Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 
      55905, USA.
FAU - Boler, Amber
AU  - Boler A
AD  - Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 
      55905, USA.
FAU - Said, Sameh M
AU  - Said SM
AD  - Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA.
FAU - Geske, Jeffrey B
AU  - Geske JB
AD  - Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 
      55905, USA.
FAU - Miranda, William R
AU  - Miranda WR
AD  - Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 
      55905, USA.
FAU - Akintoye, Emmanuel
AU  - Akintoye E
AD  - Department of Internal Medicine, Wayne State University/Detroit Medical Center, 
      3990 John R, Detroit, MI 48201, USA.
FAU - Connolly, Heidi M
AU  - Connolly HM
AD  - Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 
      55905, USA.
FAU - Warnes, Carole A
AU  - Warnes CA
AD  - Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 
      55905, USA.
FAU - Oh, Jae K
AU  - Oh JK
AD  - Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 
      55905, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Analysis of Variance
MH  - Aortic Valve Insufficiency/diagnostic imaging/*epidemiology/surgery
MH  - Aortic Valve Stenosis/diagnostic imaging/*epidemiology/surgery
MH  - Asymptomatic Diseases
MH  - Cohort Studies
MH  - Confidence Intervals
MH  - Diastole/*physiology
MH  - Echocardiography/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Physiologic/*methods
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Sex Factors
MH  - Stroke Volume/physiology
MH  - Survival Rate
MH  - United States
EDAT- 2017/06/29 06:00
MHDA- 2019/02/20 06:00
CRDT- 2017/06/29 06:00
PHST- 2017/04/20 00:00 [received]
PHST- 2017/06/09 00:00 [accepted]
PHST- 2017/06/29 06:00 [pubmed]
PHST- 2019/02/20 06:00 [medline]
PHST- 2017/06/29 06:00 [entrez]
AID - 3886031 [pii]
AID - 10.1093/ehjci/jex148 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2018 Jun 1;19(6):668-674. doi: 
      10.1093/ehjci/jex148.