TY - JOUR
T1 - Prognostic impact of combined non-severe aortic stenosis and mitral regurgitation on clinical outcomes
T2 - a single-centre retrospective study
AU - Granot, Yoav
AU - Sapir, Orly Ran
AU - Laufer-Perl, Michal
AU - Viskin, Dana
AU - Banai, Shmuel
AU - Topilsky, Yan
AU - Havakuk, Ofer
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2024.
PY - 2024/3/29
Y1 - 2024/3/29
N2 - Objectives 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. Methods 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). Results 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. Conclusion 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.
AB - Objectives 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. Methods 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). Results 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. Conclusion 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.
UR - http://www.scopus.com/inward/record.url?scp=85189720375&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2023-080914
DO - 10.1136/bmjopen-2023-080914
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C2 - 38553077
AN - SCOPUS:85189720375
SN - 2044-6055
VL - 14
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - e080914
ER -