Prognostic impact of combined non-severe aortic stenosis and mitral regurgitation on clinical outcomes: a single-centre retrospective study.

Adult cardiology Echocardiography Heart failure Valvular heart disease

Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
29 Mar 2024
Historique:
medline: 30 3 2024
pubmed: 30 3 2024
entrez: 29 3 2024
Statut: epublish

Résumé

Though the concomitant occurrence of non-severe aortic stenosis (AS) and mitral regurgitation (MR) is highly prevalent, there are limited data to guide clinical decision-making in this condition. Here, we attempt to determine an aortic valve area (AVA) cut-off value associated with worse clinical outcomes in patients with combined non-severe AS and MR. Single-centre, retrospective analysis of consecutive patients who underwent echocardiography examination between 2010 and 2021 with evidence of combined non-severe AS and MR. We excluded patients with ≥moderate aortic valve regurgitation or mitral stenosis, as well as patients who underwent any aortic or mitral intervention either prior or following our assessment (n=372). The final cohort consisted of 2933 patients with non-severe AS, 506 of them with >mild MR. Patients with both pathologies had lower cardiac output and worse diastolic function.Patients with an AVA ≤1.35 cm² in the presence of >mild MR had the highest rates of heart failure (HF) hospitalisations (HR 3.1, IQR 2.4-4, p<0.001) or mortality (HR 2, IQR 1.8-2.4, p<0.001), which remained significant after adjusting for clinical and echocardiographic parameters. Patients with combined non-severe AS and MR have a higher rate of HF hospitalisations and mortality. An AVA≤1.35 cm² in the presence of >mild MR is associated with worse clinical outcomes.

Identifiants

pubmed: 38553077
pii: bmjopen-2023-080914
doi: 10.1136/bmjopen-2023-080914
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e080914

Informations de copyright

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Yoav Granot (Y)

Icahn School of Medicine, New York, New York, USA yoavgran@gmail.com.
Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Orly Ran Sapir (OR)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, New York, USA.

Michal Laufer-Perl (M)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Dana Viskin (D)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Shmuel Banai (S)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Yan Topilsky (Y)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Ofer Havakuk (O)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Classifications MeSH