中度主动脉狭窄和中度二尖瓣狭窄患者的预后。

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Structural Heart Pub Date : 2023-09-01 DOI:10.1016/j.shj.2023.100183
Takafumi Yamane MD, Ken Kuwajima MD, Shunsuke Kagawa MD, Hiroko Hasegawa MD, Florian Rader MD, MSc, Robert J. Siegel MD, Takahiro Shiota MD
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引用次数: 0

摘要

目的:本研究旨在探讨中度主动脉瓣狭窄(AS)和二尖瓣狭窄(MS)患者的症状和预后。方法和结果:我们研究了82例经胸超声心动图诊断为中度AS和MS的患者。这些患者的平均年龄为79±13岁,95%的患者患有退行性多发性硬化症。在82名患者中,34名(41%)有心力衰竭(HF)症状(纽约心脏协会≥Ⅱ级)或有HF入院史。左心室射血分数、射血容量指数、心房颤动和右心室收缩压是HF症状的独立决定因素。中位随访时间为3.2年(四分位间距1.0-4.9),48名(59%)患者发生临床事件,其中11名(13%)患者死亡,22名(27%)患者接受主动脉瓣或二尖瓣介入治疗,15名(18%)患者HF住院治疗。无主动脉瓣或二尖瓣介入治疗、HF住院或死亡的联合终点的5年生存率为19%。临床事件的多变量预测因子是HF症状(危险比[HR],2.32;95%置信区间[CI],1.30-4.14;p=0.0045)。在没有干预的情况下,5年的Kaplan-Meier生存率为61%,HF症状与死亡率无关。结论:在中度AS和MS患者中,左心室射血分数、射血容量指数、心房颤动和右心室收缩压是HF症状的重要决定因素。HF症状可独立预测临床事件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Outcome of Patients With Both Moderate Aortic Stenosis and Moderate Mitral Stenosis

Aims

This study aimed to investigate the symptoms and prognosis of patients with both moderate aortic stenosis (AS) and mitral stenosis (MS).

Methods and Results

We studied 82 patients with moderate AS and MS diagnosed via transthoracic echocardiography. The patients had a mean age of 79 ± 13 years and 95% of patients had degenerative MS. Out of 82 patients, 34 (41%) had heart failure (HF) symptoms (New York Heart Association class ≥ Ⅱ) or a history of HF admission. Left ventricular ejection fraction, stroke volume index, atrial fibrillation, and right ventricular systolic pressure were independent determinants of HF symptoms. The median follow-up duration was 3.2 (interquartile range, 1.0-4.9) years and clinical events occurred in 48 (59%) patients, including death in 11 (13%) patients, aortic or mitral valve interventions in 22 (27%) patients, and HF hospitalization in 15 (18%) patients. The 5-year survival free of the combined endpoint of aortic or mitral valve interventions, HF hospitalization, or death was 19%. A multivariate predictor of clinical events was HF symptoms (hazard ratio [HR], 2.32; 95% confidence interval [CI], 1.30-4.14; p = 0.0045). Kaplan-Meier survival at 5 years was 61% without intervention and HF symptoms were not associated with mortality.

Conclusions

Among patients with both moderate AS and MS, left ventricular ejection fraction, stroke volume index, atrial fibrillation, and right ventricular systolic pressure were strong determinants of HF symptoms. HF symptoms were independently predictive of clinical events.

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来源期刊
Structural Heart
Structural Heart Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.60
自引率
0.00%
发文量
81
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