Vertaisarvioitu alkuperäisartikkeli tai data-artikkeli tieteellisessä aikakauslehdessä (A1)

Prognostic implications of left atrial dilation in aortic regurgitation due to bicuspid aortic valve




Julkaisun tekijät: Butcher Steele C, Fortuni Federico, Kong William, Vollema E Mara, Prevedello Francesca, Perry Rebecca, Ng Arnold Chin Tse, Poh Kian Keong, Almeida Ana G, Gonzalez-Gomez Ariana, Shen Mylène, Yeo Tiong-Chen, Shanks Miriam, Popescu Bogdan A, Galian-Gay Laura, Fijalkowski Marcin, Liang Michael, Tay Edgar, Marsan Nina Ajmone, Selvanayagam Joseph B, Pinto Fausto J, Zamorano José, Pibarot Philippe, Evangelista Arture, Bax Jeroen J, Delgado Victoria

Kustantaja: BMJ PUBLISHING GROUP

Julkaisuvuosi: 2022

Journal: Heart

Tietokannassa oleva lehden nimi: HEART

Lehden akronyymi: HEART

Volyymi: 108

Julkaisunumero: 2

Sivujen määrä: 8

ISSN: 1355-6037

eISSN: 1468-201X

DOI: http://dx.doi.org/10.1136/heartjnl-2020-318907

Verkko-osoite: https://heart.bmj.com/content/108/2/137


Tiivistelmä

Objective To investigate the prognostic value of left atrial volume index (LAVI) in patients with moderate to severe aortic regurgitation (AR) and bicuspid aortic valve (BAV).

Methods 554 individuals (45 (IQR 33-57) years, 80% male) with BAV and moderate or severe AR were selected from an international, multicentre registry. The association between LAVI and the combined endpoint of all-cause mortality or aortic valve surgery was investigated with Cox proportional hazard regression analyses.

Results Dilated LAVI was observed in 181 (32.7%) patients. The mean indexed aortic annulus, sinus of Valsalva, sinotubular junction and ascending aorta diameters were 13.0 ± 2.0 mm/m2, 19.4 ± 3.7 mm/m2, 16.5 ± 3.8 mm/m2 and 20.4 ± 4.5 mm/m2, respectively. After a median follow-up of 23 (4-82) months, 272 patients underwent aortic valve surgery (89%) or died (11%). When compared with patients with normal LAVI (<35 mL/m2), those with a dilated LAVI (>= 35 mL/m2) had significantly higher rates of aortic valve surgery or mortality (43% and 60% vs 23% and 36%, at 1 and 5 years of follow-up, respectively, p<0.001). Dilated LAVI was independently associated with reduced event-free survival (HR=1.450, 95% CI 1.085 to 1.938, p=0.012) after adjustment for LV ejection fraction, aortic root diameter, LV end-diastolic diameter and LV end-systolic diameter.

Conclusions In this large, multicentre registry of patients with BAV and moderate to severe AR, left atrial dilation was independently associated with reduced event-free survival. The role of this parameter for the risk stratification of individuals with significant AR merits further investigation.


Last updated on 2022-14-01 at 12:08