PMID- 36039483
OWN - NLM
STAT- MEDLINE
DCOM- 20220916
LR  - 20220920
IS  - 1540-8175 (Electronic)
IS  - 0742-2822 (Linking)
VI  - 39
IP  - 9
DP  - 2022 Sep
TI  - Predictors of heart failure and all-cause mortality in asymptomatic patients with 
      moderate and severe aortic regurgitation.
PG  - 1219-1232
LID - 10.1111/echo.15436 [doi]
AB  - BACKGROUND: Class I indications for aortic valve replacement (AVR) for severe 
      chronic aortic regurgitation (AR) include AR attributable symptoms or left 
      ventricular (LV) ejection fraction <50%. As noninvasive estimates of elevated LV 
      filling pressures (LVFP's) have been noted to predict heart failure (HF) 
      readmission and all-cause mortality (ACM) in HF patients, we hypothesize that 
      elevated LVFP's may also be independent predictors of HF and ACM in chronic AR. 
      METHODS: We developed a single center patient database of moderate or greater AR 
      diagnoses between 2003 and 2008 and followed each patient through January 2013. 
      We included patients with >30 days follow-up with interpretable 
      Doppler-echocardiograms. We recorded demographic variables, EuroScore II, 
      incident HF and ACM, and Doppler-echo variables of LV size, systolic and 
      diastolic function. RESULTS: Patients with severe AR (105 patients) and moderate 
      AR (201 patients) had similar EuroScore II values and similar incident HF and 
      ACM. For the 180 patients who developed HF, effective arterial elastance 
      (aHR = 1.70 (1.01-2.83), p = .041), LV end-diastolic dimension (aHR = 1.83, 
      (1.11-3.03), p = .0176), E/e' (aHR = 3.04, (1.83-5.05), p < .0001), eccentric 
      hypertrophy (EH) (aHR = 2.39, (1.62-5.12), p = .0004), and tricuspid 
      regurgitation (TR) velocity (aHR = 5.75, (3.70-10.36), p < .0001) were 
      independent predictors. For the 118 patients with ACM, EH (aHR = 1.73, 
      (1.02-3.28), p = .0414), systolic blood pressure (aHR = .58, (.33-.95), 
      p = .0301), left atrial volume index (aHR = 1.82, (1.06-3.06), p = .0293), E/e' 
      (aHR = 1.83, (1.07-3.08), p = .0280), and TR velocity (aHR = 4.14, (2.22-6.49), 
      p < .0001) were independent predictors. CONCLUSIONS: Elevated TR velocity and EH 
      were strong markers of HF and ACM in patients with asymptomatic severe AR and in 
      moderate AR.
CI  - (c) 2022 Wiley Periodicals LLC.
FAU - Lavine, Steven J
AU  - Lavine SJ
AD  - Washington University of St. Louis, St. Louis, Missouri, USA.
AD  - UF Health-Jacksonville, Jacksonville, Florida, USA.
FAU - Raby, Kirsten
AU  - Raby K
AD  - Quillen College of Medicine, East Tennessee State University, Johnson City, 
      Tennessee, USA.
LA  - eng
PT  - Journal Article
DEP - 20220829
PL  - United States
TA  - Echocardiography
JT  - Echocardiography (Mount Kisco, N.Y.)
JID - 8511187
SB  - IM
MH  - Aortic Valve/surgery
MH  - *Aortic Valve Insufficiency/complications/diagnostic imaging
MH  - *Heart Failure/diagnostic imaging
MH  - Humans
MH  - Stroke Volume
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - all-cause mortality
OT  - aortic regurgitation
OT  - diastolic function
OT  - heart failure
EDAT- 2022/08/31 06:00
MHDA- 2022/09/17 06:00
CRDT- 2022/08/30 02:33
PHST- 2022/07/18 00:00 [revised]
PHST- 2021/12/10 00:00 [received]
PHST- 2022/07/26 00:00 [accepted]
PHST- 2022/08/31 06:00 [pubmed]
PHST- 2022/09/17 06:00 [medline]
PHST- 2022/08/30 02:33 [entrez]
AID - 10.1111/echo.15436 [doi]
PST - ppublish
SO  - Echocardiography. 2022 Sep;39(9):1219-1232. doi: 10.1111/echo.15436. Epub 2022 
      Aug 29.