Impact of aortic plaque on progression rate and prognosis of aortic stenosis

被引:3
作者
Nishimura, Shunsuke [1 ]
Izumi, Chisato [1 ]
Imanaka, Miyako [1 ]
Kuroda, Maiko [1 ]
Takahashi, Yusuke [1 ]
Yoshikawa, Yusuke [1 ]
Amano, Masashi [1 ]
Onishi, Naoaki [1 ]
Sakamoto, Jiro [1 ]
Tamaki, Yodo [1 ]
Enomoto, Soichiro [1 ]
Miyake, Makoto [1 ]
Tamura, Toshihiro [1 ]
Kondo, Hirokazu [1 ]
Kaitani, Kazuaki [1 ]
Nakagawa, Yoshihisa [1 ]
机构
[1] Tenri Hosp, Dept Cardiol, 200 Mishima Cho, Tenri, Nara 6328552, Japan
关键词
Aortic stenosis; Aortic plaque; Echocardiography; Valvular heart disease; THORACIC AORTA; ATHEROSCLEROTIC DISEASE; ACCELERATED PROGRESSION; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; EARLY LESION; PREDICTORS; RISK; ECHOCARDIOGRAPHY; ATHEROMAS;
D O I
10.1016/j.ijcard.2017.09.181
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Backgrounds: Patients with aortic stenosis (AS) have a high prevalence of aortic plaque. However, no data exist regarding the clinical significance and prognostic value of aortic plaque in AS patients. This study examines the impact of aortic plaque on the rate of progression and clinical outcomes of AS. Methods: We retrospectively investigated 1812 transesophageal echocardiographic examinations between 2008 and 2015. We selected 100 consecutive patients (mean age: 75.1 +/- 7.4 years) who showed maximal aortic jet velocity (AV-Vel) >= 2.0 m/s by transthoracic echocardiography (TTE) and received follow-up TTE (mean follow-up duration 25 +/- 17 months), and the mean progression rate of AV-Vel was calculated. Clinical and echocardiographic characteristics, including severity of aortic plaque, and cardiac events were examined. Results: At initial TIE, mean AV-Vel was 3.68 +/- 0.94 m/s and mean aortic valve area 0.98 +/- 0.32 cm(2). Mean progression rate of AV-Vel was 0.41 m/s/year in 38 patients with severe aortic plaque, and -0.03 m/s/year in the remaining 62 patients without severe aortic plaque. Severe aortic plaque (odds ratio[OR], 8.32) and hemodialysis (OR, 6.03) were independent predictors of rapid progression. The event-free survival rate at 3 years was significantly lower in patients with severe aortic plaque than in those without (52% vs 82%, p = 0.002). Severe aortic plaque (hazard ratio[HR], 2.89) and AV-Vel at initial TTE (HR, 3.28) were identified as independent predictors of cardiac events. Conclusion: Severe aortic plaque was a predictor of rapid progression and poor prognosis in AS patients. Evaluation of aortic plaque provides additional information regarding surgical scheduling and follow-up. (C) 2017 Elsevier B.V. All rights reserved.
引用
收藏
页码:144 / 149
页数:6
相关论文
共 32 条
[1]   ATHEROSCLEROTIC DISEASE OF THE AORTIC-ARCH AND THE RISK OF ISCHEMIC STROKE [J].
AMARENCO, P ;
COHEN, A ;
TZOURIO, C ;
BERTRAND, B ;
HOMMEL, M ;
BESSON, G ;
CHAUVEL, C ;
TOUBOUL, PJ ;
BOUSSER, MG .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (22) :1474-1479
[2]   Atherosclerosis of the Aorta in Patients With Acute Thoracic Aortic Dissection [J].
Barbetseas, John ;
Alexopoulos, Nikolaos ;
Brili, Stella ;
Aggeli, Constadina ;
Chrysohoou, Christina ;
Frogoudaki, Alexandra ;
Vyssoulis, Gregory ;
Pitsavos, Christos ;
Stefanadis, Christodoulos .
CIRCULATION JOURNAL, 2008, 72 (11) :1773-1776
[3]   In vivo magnetic resonance evaluation of atherosclerotic plaques in the human thoracic aorta - A comparison with transesophageal echocardiography [J].
Fayad, ZA ;
Nahar, T ;
Fallon, JT ;
Goldman, M ;
Aguinaldo, JG ;
Badimon, JJ ;
Shinnar, M ;
Chesebro, JH ;
Fuster, V .
CIRCULATION, 2000, 101 (21) :2503-2509
[4]   TRANSESOPHAGEAL ECHOCARDIOGRAPHICALLY DETECTED ATHEROSCLEROTIC AORTIC PLAQUE IS A MARKER FOR CORONARY-ARTERY DISEASE [J].
FAZIO, GP ;
REDBERG, RF ;
WINSLOW, T ;
SCHILLER, NB .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1993, 21 (01) :144-150
[5]   Thoracic aortic arteriosclerosis in patients with degenerative aortic stenosis with and without coexisting coronary artery disease [J].
Goland, Sorel ;
Trento, Alfredo ;
Czer, Lawrence S. C. ;
Eshaghian, Shervin ;
Tolstrup, Kirsten ;
Naqvi, Tasneem Z. ;
De Robertis, Michele A. ;
Mirocha, James ;
Iida, Kiyoshi ;
Siegel, Robert J. .
ANNALS OF THORACIC SURGERY, 2008, 85 (01) :113-119
[6]   Multimodality Imaging of Diseases of the Thoracic Aorta in Adults: From the American Society of Echocardiography and the European Association of Cardiovascular Imaging Endorsed by the Society of Cardiovascular Computed Tomography and Society for Cardiovascular Magnetic Resonance [J].
Goldstein, Steven A. ;
Evangelista, Arturo ;
Abbara, Suhny ;
Arai, Andrew ;
Asch, Federico M. ;
Badano, Luigi P. ;
Bolen, Michael A. ;
Connolly, Heidi M. ;
Cuellar-Calabria, Hug ;
Czerny, Martin ;
Devereux, Richard B. ;
Erbel, Raimund A. ;
Fattori, Rossella ;
Isselbacher, Eric M. ;
Lindsay, Joseph M. ;
McCulloch, Marti ;
Michelena, Hector I. ;
Nienaber, Christoph A. ;
Oh, Jae K. ;
Pepi, Mauro ;
Taylor, Allen J. ;
Weinsaft, Jonathan W. ;
Zamorano, Jose Luis ;
Dietz, Harry ;
Eagle, Kim ;
Elefteriades, John ;
Jondeau, Guillaume ;
Rousseau, Herve ;
Schepens, Marc .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2015, 28 (02) :119-182
[7]   Relation Between the Incidence, Location, and Extent of Thoracic Aortic Atherosclerosis Detected by Transesophageal Echocardiography and the Extent of Coronary Artery Disease by Angiography [J].
Gu, Xiaoyan ;
He, Yihua ;
Li, Zhian ;
Kontos, Michael C. ;
Paulsen, Walter H. J. ;
Arrowood, James A. ;
Vetrovec, George W. ;
Nixon, J. V. .
AMERICAN JOURNAL OF CARDIOLOGY, 2011, 107 (02) :175-178
[8]  
Harold JG, 2014, J AM COLL CARDIOL, V63, pE57, DOI [10.1016/j.jacc.2014.02.537, 10.1016/j.jacc.2014.02.536, 10.1016/j.jtcvs.2014.05.014]
[9]   A prospective survey of patients with valvular heart disease in Europe:: The Euro Heart Survey on Valvular Heart Disease [J].
Iung, B ;
Baron, G ;
Butchart, EG ;
Delahaye, F ;
Gohlke-Bärwolf, C ;
Levang, OW ;
Tornos, P ;
Vanoverschelde, JL ;
Vermeer, F ;
Boersma, E ;
Ravaud, P ;
Vahanian, A .
EUROPEAN HEART JOURNAL, 2003, 24 (13) :1231-1243
[10]   Impact of Aortic Plaque Morphology on Survival Rate and Incidence of a Subsequent Embolic Event - Long-Term Follow-up Data - [J].
Izumi, Chisato ;
Takahashi, Shuichi ;
Miyake, Makoto ;
Sakamoto, Jiro ;
Hanazawa, Koji ;
Yoshitani, Kazuyasu ;
Kaitani, Kazuaki ;
Izumi, Toshiaki ;
Gen, Hiromitsu ;
Nakagawa, Yoshihisa .
CIRCULATION JOURNAL, 2010, 74 (10) :2152-2157