PMID- 37692041
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230913
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 10
DP  - 2023
TI  - Clinical impact of aortic valve replacement in patients with moderate mixed 
      aortic valve disease.
PG  - 1259188
LID - 10.3389/fcvm.2023.1259188 [doi]
LID - 1259188
AB  - BACKGROUND: Information is scarce regarding the clinical implications of aortic 
      valve replacement (AVR) for patients suffering from moderate mixed aortic valve 
      disease (MAVD), characterized by a combination of moderate aortic stenosis (AS) 
      and regurgitation (AR). The objective of this retrospective study was to explore 
      the clinical effects of AVR in individuals with moderate MAVD. METHODS: We 
      examined the clinical data from patients with moderate MAVD and preserved left 
      ventricular ejection fraction, who had undergone echocardiography in the period 
      spanning from 2010 to 2018. Moderate AS was defined as aortic valve area index of 
      0.60-0.85 cm(2)/m(2) and peak velocity of 3.0-4.0 m/s. Moderate AR was defined as 
      a vena contracta width of 3.0-6.0 mm. The primary endpoint was a composite of 
      all-cause death and heart failure hospitalization. RESULTS: Among 88 patients 
      (mean age, 74.4 +/- 6.8 years; 48.9%, men), 44 (50.0%) required AVR during a median 
      follow-up period of 3.3 years (interquartile range, 0.5-4.9). Mean values of 
      specific aortic valve variables are as follows: aortic valve area index, 
      0.64 +/- 0.04 cm(2)/m(2); peak velocity, 3.40 +/- 0.30 m/s; and vena contracta width, 
      4.1 +/- 0.7 mm. The primary endpoint occurred in 32 (36.4%) patients during a 
      median follow-up duration of 5.3 years (interquartile range, 3.2-8.0). 
      Multivariable analysis revealed that AVR was significantly associated with the 
      endpoint (hazard ratio, 0.248; 95% confidence interval, 0.107-0.579; p = 0.001) 
      after adjusting for age, B-type natriuretic peptide, and the Charlson comorbidity 
      index. Patients who underwent AVR during follow-up had significantly lower 
      incidence rates of the endpoint than those managed with medical treatment (10.2% 
      vs. 44.1% at 5 years; p < 0.001). CONCLUSIONS: Approximately half of the patients 
      diagnosed with moderate MAVD eventually necessitated AVR throughout the period of 
      observation, leading to positive clinical results. Vigilant tracking of these 
      patients and watchful monitoring for signs requiring AVR during this time frame 
      are essential.
CI  - (c) 2023 Onishi, Izumo, Ouchi, Yuki, Naganuma, Nakao and Nakamura.
FAU - Onishi, Hirokazu
AU  - Onishi H
AD  - Department of Cardiology, New Tokyo Hospital, Chiba, Japan.
AD  - Department of Cardiology, St. Marianna University School of Medicine, Kanagawa, 
      Japan.
FAU - Izumo, Masaki
AU  - Izumo M
AD  - Department of Cardiology, St. Marianna University School of Medicine, Kanagawa, 
      Japan.
FAU - Ouchi, Toru
AU  - Ouchi T
AD  - Department of Cardiology, New Tokyo Hospital, Chiba, Japan.
FAU - Yuki, Haruhito
AU  - Yuki H
AD  - Department of Cardiology, New Tokyo Hospital, Chiba, Japan.
FAU - Naganuma, Toru
AU  - Naganuma T
AD  - Department of Cardiology, New Tokyo Hospital, Chiba, Japan.
FAU - Nakao, Tatsuya
AU  - Nakao T
AD  - Department of Cardiovascular Surgery, New Tokyo Hospital, Chiba, Japan.
FAU - Nakamura, Sunao
AU  - Nakamura S
AD  - Department of Cardiology, New Tokyo Hospital, Chiba, Japan.
LA  - eng
PT  - Journal Article
DEP - 20230823
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC10484795
OTO - NOTNLM
OT  - aortic regurgitation
OT  - aortic stenosis
OT  - aortic valve replacement
OT  - heart failure
OT  - mixed aortic valve disease
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/09/11 06:43
MHDA- 2023/09/11 06:44
PMCR- 2023/01/01
CRDT- 2023/09/11 04:31
PHST- 2023/07/15 00:00 [received]
PHST- 2023/08/07 00:00 [accepted]
PHST- 2023/09/11 06:44 [medline]
PHST- 2023/09/11 06:43 [pubmed]
PHST- 2023/09/11 04:31 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2023.1259188 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2023 Aug 23;10:1259188. doi: 10.3389/fcvm.2023.1259188. 
      eCollection 2023.