Outcome of Patients With Both Moderate Aortic Stenosis and Moderate Mitral Stenosis

被引:0
作者
Yamane, Takafumi [1 ]
Kuwajima, Ken [1 ]
Kagawa, Shunsuke [1 ]
Hasegawa, Hiroko [1 ]
Rader, Florian [1 ]
Siegel, Robert J. [1 ]
Shiota, Takahiro [1 ]
机构
[1] Cedars Sinai Med Ctr, Smidt Heart Inst, Los Angeles, CA 90048 USA
来源
STRUCTURAL HEART-THE JOURNAL OF THE HEART TEAM | 2023年 / 7卷 / 05期
关键词
Aortic stenosis; Heart failure; Mitral stenosis; Stroke volume index; AMERICAN SOCIETY; EUROPEAN ASSOCIATION; VALVE-REPLACEMENT; NATURAL-HISTORY; ECHOCARDIOGRAPHIC-ASSESSMENT; EJECTION FRACTION; LOW-GRADIENT; LOW-FLOW; HEART; RECOMMENDATIONS;
D O I
10.1016/j.shj.2023.100183
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: This study aimed to investigate the symptoms and prognosis of patients with both moderate aortic stenosis (AS) and mitral stenosis (MS).Methods and Results: We studied 82 patients with moderate AS and MS diagnosed via transthoracic echocardiography. The patients had a mean age of 79 +/- 13 years and 95% of patients had degenerative MS. Out of 82 patients, 34 (41%) had heart failure (HF) symptoms (New York Heart Association class >= II) or a history of HF admission. Left ventricular ejection fraction, stroke volume index, atrial fibrillation, and right ventricular systolic pressure were independent determinants of HF symptoms. The median follow-up duration was 3.2 (interquartile range, 1.0-4.9) years and clinical events occurred in 48 (59%) patients, including death in 11 (13%) patients, aortic or mitral valve interventions in 22 (27%) patients, and HF hospitalization in 15 (18%) patients. The 5-year survival free of the combined endpoint of aortic or mitral valve interventions, HF hospitalization, or death was 19%. A multivariate predictor of clinical events was HF symptoms (hazard ratio [HR], 2.32; 95% confidence interval [CI], 1.30-4.14; p 1/4 0.0045). Kaplan-Meier survival at 5 years was 61% without intervention and HF symptoms were not associated with mortality. Conclusions: Among patients with both moderate AS and MS, left ventricular ejection fraction, stroke volume index, atrial fibrillation, and right ventricular systolic pressure were strong determinants of HF symptoms. HF symptoms were independently predictive of clinical events.
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页数:7
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