Mid-term effect of balloon aortic valvuloplasty on mitral regurgitation in aortic stenosis.
Aged, 80 and over
Aortic Valve
/ diagnostic imaging
Aortic Valve Stenosis
/ diagnosis
Balloon Valvuloplasty
/ methods
Echocardiography
/ methods
Female
Follow-Up Studies
Humans
Male
Myocardial Contraction
/ physiology
Retrospective Studies
Severity of Illness Index
Systole
Time Factors
Treatment Outcome
Aortic stenosis
Balloon aortic valvuloplasty
Mitral regurgitation
Journal
Cardiovascular ultrasound
ISSN: 1476-7120
Titre abrégé: Cardiovasc Ultrasound
Pays: England
ID NLM: 101159952
Informations de publication
Date de publication:
13 Apr 2020
13 Apr 2020
Historique:
received:
18
01
2020
accepted:
02
04
2020
entrez:
15
4
2020
pubmed:
15
4
2020
medline:
31
12
2020
Statut:
epublish
Résumé
Balloon aortic valvuloplasty (BAV) offers an alternative to conventional aortic valve replacement in elderly and frail patients with severe aortic stenosis (AS) for whom there are no other effective options. We aimed to investigate the mid-term effect of BAV on mitral regurgitation (MR) in patients with severe AS. Our analysis was based on the data from 83 patients with severe AS (mean age, 86 ± 5 years; female, 68) treated using BAV. Echocardiography was performed before the procedure and at 1 and 3 months after. MR was quantified by measuring the MR jet area, with more-than-moderate MR being clinically significant. Forty patients were classified in this group (MR group). Significant reduction of MR was observed in the MR group at 1 month and 3 months after procedure, with no improvement in patients in the non-MR group. At 3 months, 15 of the 40 patients in the MR group still had significant MR, with the change at 1 month in the left ventricular end-systolic dimension (OR: 1.36; 95% CI: 1.05-1.76; P = 0.022) and MR jet area (OR: 1.95; 95% CI: 1.16-3.29; P = 0.012) being predictive of persisting significant MR at 3 months after BAV. The prevalence of New York Heart Association functional class III or IV decreased at 1 and 3 months after BAV in both groups. BAV provides a useful therapeutic strategy for elderly patients with severe AS who are not candidates for surgical or transcatheter aortic valve replacement, especially in those with significant MR.
Sections du résumé
BACKGROUND
BACKGROUND
Balloon aortic valvuloplasty (BAV) offers an alternative to conventional aortic valve replacement in elderly and frail patients with severe aortic stenosis (AS) for whom there are no other effective options. We aimed to investigate the mid-term effect of BAV on mitral regurgitation (MR) in patients with severe AS.
METHODS
METHODS
Our analysis was based on the data from 83 patients with severe AS (mean age, 86 ± 5 years; female, 68) treated using BAV. Echocardiography was performed before the procedure and at 1 and 3 months after. MR was quantified by measuring the MR jet area, with more-than-moderate MR being clinically significant.
RESULTS
RESULTS
Forty patients were classified in this group (MR group). Significant reduction of MR was observed in the MR group at 1 month and 3 months after procedure, with no improvement in patients in the non-MR group. At 3 months, 15 of the 40 patients in the MR group still had significant MR, with the change at 1 month in the left ventricular end-systolic dimension (OR: 1.36; 95% CI: 1.05-1.76; P = 0.022) and MR jet area (OR: 1.95; 95% CI: 1.16-3.29; P = 0.012) being predictive of persisting significant MR at 3 months after BAV. The prevalence of New York Heart Association functional class III or IV decreased at 1 and 3 months after BAV in both groups.
CONCLUSIONS
CONCLUSIONS
BAV provides a useful therapeutic strategy for elderly patients with severe AS who are not candidates for surgical or transcatheter aortic valve replacement, especially in those with significant MR.
Identifiants
pubmed: 32284072
doi: 10.1186/s12947-020-00193-3
pii: 10.1186/s12947-020-00193-3
pmc: PMC7155284
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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