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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 791 - 800 (10page)
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초록· 키워드
오류제보하기
Background and Objectives: Severe aortic stenosis (AS) with left ventricular systolic dysfunction (LVSD) is a class I indication for aortic valve replacement (AVR) but this recommendation is not well established in those at the stage of moderate AS. We investigate the clinical impact of AVR among patients with moderate AS and LVSD. Methods: From 2001 to 2017, we consecutively identified patients with moderate AS and LVSD, defined as aortic valve area 1.0–1.5 cm2 and left ventricular ejection fraction <50%. The primary outcome was all-cause death. The outcomes were compared between those who underwent early surgical AVR (within 2 years of index echocardiography) at the stage of moderate AS versus those who were followed medically without AVR at the outpatient clinic. Results: Among 255 patients (70.1±11.3 years, male 62%), 37 patients received early AVR. The early AVR group was younger than the medical observation group (63.1±7.9 vs. 71.3±11.4) with a lower prevalence of hypertension and chronic kidney disease. During a median 1.8-year follow up, 121 patients (47.5%) died, and the early AVR group showed a significantly lower all-cause death rate than the medical observation group (5.03PY vs. 18.80PY, p<0.001). After multivariable Cox-proportional hazard regression adjusting for age, sex, comorbidities, and laboratory data, early AVR at the stage of moderate AS significantly reduced the risk of death (hazard ratio, 0.43; 95% confidence interval 0.20–0.91; p=0.028). Conclusions: In patients with moderate AS and LVSD, AVR reduces the risk of all-cause death. A prospective randomized trial is warranted to confirm our findings.
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등록된 정보가 없습니다.
참고문헌 (19)
참고문헌 신청
Osnabrugge RL / 2013 / Aortic stenosis in the elderly : disease prevalence and number of candidates for transcatheter aortic valve replacement : a meta-analysis and modeling study / J Am Coll Cardiol 62:1002~1012
Baumgartner H / 2017 / 2017 ESC/EACTS guidelines for the management of valvular heart disease / Eur Heart J 38:2739~2791
Nishimura RA / 2014 / 2014 AHA/ACC guideline for the management of patients with valvular heart disease : a report of the American College of Cardiology/American Heart Association task force on practice guidelines / J Am Coll Cardiol 63:e57~185
Ito S / 2020 / Left ventricular contractility and wall stress in patients with aortic stenosis with preserved or reduced ejection fraction / JACC Cardiovasc Imaging 13:357~369
Strange G / 2019 / Poor long-term survival in patients with moderate aortic stenosis / J Am Coll Cardiol 74:1851~1863
Baumgartner H / 2017 / 2017 ESC/EACTS guidelines for the management of valvular heart disease / Eur Heart J 38:2739~2791
Nishimura RA / 2014 / 2014 AHA/ACC guideline for the management of patients with valvular heart disease : a report of the American College of Cardiology/American Heart Association task force on practice guidelines / J Am Coll Cardiol 63:e57~185
Ito S / 2020 / Left ventricular contractility and wall stress in patients with aortic stenosis with preserved or reduced ejection fraction / JACC Cardiovasc Imaging 13:357~369
Strange G / 2019 / Poor long-term survival in patients with moderate aortic stenosis / J Am Coll Cardiol 74:1851~1863
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