PMID- 36075677
OWN - NLM
STAT- MEDLINE
DCOM- 20220913
LR  - 20230323
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 80
IP  - 11
DP  - 2022 Sep 13
TI  - Impact of Left Ventricular Ejection Fraction on Clinical Outcomes in 
      Bicuspid Aortic Valve Disease.
PG  - 1071-1084
LID - S0735-1097(22)05539-5 [pii]
LID - 10.1016/j.jacc.2022.06.032 [doi]
AB  - BACKGROUND: The prognostic impact of left ventricular ejection fraction (LVEF) in 
      patients with bicuspid aortic valve (BAV) disease has not been previously 
      studied. OBJECTIVES: The purpose of this study was to determine the prognostic 
      impact of LVEF in BAV patients according to the type of aortic valve dysfunction. 
      METHODS: We retrospectively analyzed the data collected in 2,672 patients 
      included in an international registry of patients with BAV. Patients were 
      classified according to the type of aortic valve dysfunction: isolated aortic 
      stenosis (AS) (n = 749), isolated aortic regurgitation (AR) (n = 554), mixed 
      aortic valve disease (MAVD) (n = 190), or no significant aortic valve dysfunction 
      (n = 1,179; excluded from this analysis). The study population was divided 
      according to LVEF strata to investigate its impact on clinical outcomes. RESULTS: 
      The risk of all-cause mortality and the composite endpoint of aortic valve 
      replacement or repair (AVR) and all-cause mortality increased when LVEF was <60% 
      in the whole cohort as well as in the AS and AR groups, and when LVEF was <55% in 
      MAVD group. In multivariable analysis, LVEF strata were significantly associated 
      with increased rate of mortality (LVEF 50%-59%: HR: 1.83 [95% CI: 1.09-3.07]; P = 
      0.022; LVEF 30%-49%: HR: 1.97 [95% CI: 1.13-3.41]; P = 0.016; LVEF <30%: HR: 4.20 
      [95% CI: 2.01-8.75]; P < 0.001; vs LVEF 60%-70%, reference group). CONCLUSIONS: 
      In BAV patients, the risk of adverse clinical outcomes increases significantly 
      when the LVEF is <60%. These findings suggest that LVEF cutoff values proposed in 
      the guidelines to indicate intervention should be raised from 50% to 60% in AS or 
      AR and 55% in MAVD.
CI  - Copyright (c) 2022 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Hecht, Sebastien
AU  - Hecht S
AD  - Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada.
FAU - Butcher, Steele C
AU  - Butcher SC
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, the 
      Netherlands; Department of Cardiology, Royal Perth Hospital, Perth, Western 
      Australia, Australia.
FAU - Pio, Stephan M
AU  - Pio SM
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, the 
      Netherlands.
FAU - Kong, William K F
AU  - Kong WKF
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, the 
      Netherlands; Department of Cardiology, National University Heart Centre, National 
      University Health System, Singapore, Singapore.
FAU - Singh, Gurpreet K
AU  - Singh GK
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, the 
      Netherlands.
FAU - Ng, Arnold C T
AU  - Ng ACT
AD  - Department of Cardiology, Princess Alexandra Hospital, The University of 
      Queensland, Brisbane, Queensland, Australia.
FAU - Perry, Rebecca
AU  - Perry R
AD  - Department of Cardiovascular Medicine, Flinders Medical Centre, Bedford Park, 
      Adelaide, South Australia, Australia.
FAU - Poh, Kian Keong
AU  - Poh KK
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, Singapore, Singapore.
FAU - Almeida, Ana G
AU  - Almeida AG
AD  - Cardiology Department, Santa Maria University Hospital (CHLN), CAML, CCUL, Lisbon 
      School of Medicine of the Universidade de Lisboa, Lisbon, Portugal.
FAU - Gonzalez, Ariana
AU  - Gonzalez A
AD  - Department of Cardiology, Hospital Universitario Ramon y Cajal, Madrid, Spain.
FAU - Shen, Mylene
AU  - Shen M
AD  - Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada.
FAU - Yeo, Tiong Cheng
AU  - Yeo TC
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, Singapore, Singapore.
FAU - Shanks, Miriam
AU  - Shanks M
AD  - Division of Cardiology, University of Alberta, Mazankowski Alberta Heart 
      Institute, Edmonton, Alberta, Canada.
FAU - Popescu, Bogdan A
AU  - Popescu BA
AD  - University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Institute of 
      Cardiovascular Diseases "Prof. Dr C. C. Iliescu," Bucharest, Romania.
FAU - Gay, Laura Galian
AU  - Gay LG
AD  - Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
FAU - Fijalkowski, Marcin
AU  - Fijalkowski M
AD  - First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.
FAU - Liang, Michael
AU  - Liang M
AD  - Department of Cardiology, Khoo Teck Puat Hospital, Singapore, Singapore.
FAU - Tay, Edgar
AU  - Tay E
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, Singapore, Singapore.
FAU - Marsan, Nina Ajmone
AU  - Marsan NA
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, the 
      Netherlands.
FAU - Selvanayagam, Joseph
AU  - Selvanayagam J
AD  - Department of Cardiovascular Medicine, Flinders Medical Centre, Bedford Park, 
      Adelaide, South Australia, Australia.
FAU - Pinto, Fausto
AU  - Pinto F
AD  - Cardiology Department, Santa Maria University Hospital (CHLN), CAML, CCUL, Lisbon 
      School of Medicine of the Universidade de Lisboa, Lisbon, Portugal.
FAU - Zamorano, Jose L
AU  - Zamorano JL
AD  - Department of Cardiology, Hospital Universitario Ramon y Cajal, Madrid, Spain.
FAU - Evangelista, Arturo
AU  - Evangelista A
AD  - Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
FAU - Delgado, Victoria
AU  - Delgado V
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, the 
      Netherlands.
FAU - Bax, Jeroen J
AU  - Bax JJ
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, the 
      Netherlands; Heart Center, University of Turku and Turku University Hospital, 
      Turku, Finland. Electronic address: j.j.bax@lumc.nl.
FAU - Pibarot, Philippe
AU  - Pibarot P
AD  - Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada. 
      Electronic address: philippe.pibarot@med.ulaval.ca.
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. 2022 Sep 13;80(11):1085-1087. PMID: 36075678
CIN - J Cardiothorac Vasc Anesth. 2023 Feb;37(2):198-200. PMID: 36424237
CIN - J Am Coll Cardiol. 2023 Jan 24;81(3):e23. PMID: 36653097
CIN - J Am Coll Cardiol. 2023 Jan 24;81(3):e25. PMID: 36653098
MH  - Aortic Valve/surgery
MH  - *Aortic Valve Insufficiency/surgery
MH  - *Aortic Valve Stenosis
MH  - *Bicuspid Aortic Valve Disease
MH  - *Heart Valve Prosthesis Implantation/adverse effects
MH  - Humans
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - aortic regurgitation
OT  - aortic stenosis
OT  - bicuspid aortic valve
OT  - left ventricular ejection fraction
OT  - mixed aortic valve disease
COIS- Funding Support and Author Disclosures The Department of Cardiology of the Leiden 
      University Medical Center has received research grants from Abbott Vascular, 
      Bioventrix, Medtronic, Biotronik, Boston Scientific, GE Healthcare, and Edwards 
      Lifesciences. Dr Butcher has received funding from the European Society of 
      Cardiology (ESC Research Grant App000080404). Drs Marsan and Bax have received 
      speaker fees from Abbott Vascular. Dr Delgado has received speaker fees from 
      Abbott Vascular, Medtronic, Edwards Lifesciences, Merck Sharp & Dohme, Novartis, 
      and GE Healthcare. Dr Pibarot holds the Canada Research Chair in Valvular Heart 
      Diseases, Canadian Institutes of Health Research; and has received funding from 
      Edwards Lifesciences and Medtronic for echocardiography CoreLab analyses with no 
      personal compensation. All other authors have reported that they have no 
      relationships relevant to the contents of this paper to disclose.
EDAT- 2022/09/09 06:00
MHDA- 2022/09/14 06:00
CRDT- 2022/09/08 21:05
PHST- 2022/05/05 00:00 [received]
PHST- 2022/06/13 00:00 [revised]
PHST- 2022/06/21 00:00 [accepted]
PHST- 2022/09/08 21:05 [entrez]
PHST- 2022/09/09 06:00 [pubmed]
PHST- 2022/09/14 06:00 [medline]
AID - S0735-1097(22)05539-5 [pii]
AID - 10.1016/j.jacc.2022.06.032 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2022 Sep 13;80(11):1071-1084. doi: 10.1016/j.jacc.2022.06.032.