Clinical and echocardiographic predictors of long-term outcome of a large cohort of patients with bicuspid aortic valve.
J Cardiovasc Med (Hagerstown)
; 18(2): 74-82, 2017 Feb.
Article
en En
| MEDLINE
| ID: mdl-27606785
ABSTRACT
BACKGROUND AND OBJECTIVES:
Bicuspid aortic valve (BAV) disease is the most common congenital cardiac malformation. The aim of the present article is to determine clinical and echocardiographic prognostic factors and provide a predictive model of outcome of a large cohort of patients with BAV.METHODS:
We retrospectively enrolled 337 patients consecutively assessed for echocardiography at our Cardiology Department from 1993 to 2014. We considered aortic valve replacement, aortic surgery and cardiovascular death as a clinical combined end-point. Predictors of outcome were determined by Cox regression.RESULTS:
Mean age was 29.2â±â19.8 years, median 27.1 years. A total of 38.4% patients presented a history of hypertension. Mean duration of follow-up was 8.4â±â6.1âyears, range 0-21 years. A total of 73 patients underwent aortic valve replacement and/or aortic surgery during follow-up. Age at surgery was 45.2â±â15.6 years. Seven patients died because of cardiovascular causes. At multivariate analysis, baseline clinical predictors were history of hypertension [hazard ratio (HR) 2.289, 95% confidence interval (CI) 1.350-3.881, Pâ=â0.002], larger ascending aortic diameter (HR 2.537, 95% CI 1.888-3.410, Pâ<â0.001), moderate-to-severe aortic regurgitation (HR 2.266, 95% CI 1.402-3.661, Pâ=â0.001) and moderate-to-severe aortic stenosis (HR 2.807, 95% CI 1.476-5.338, Pâ=â0.002). A predictive model was created by integrating these four independent covariates. It allows the calculation of calculate a risk score for each patient, which helps better tailor appropriate treatment in BAV patients.CONCLUSION:
At enrolment, history of hypertension, a wider aortic diameter, moderate-to-severe aortic regurgitation and aortic stenosis were independently correlated to combined end-point. Long-term follow-up showed low cardiovascular mortality (2.1%) and a high prevalence of cardiac surgery (21.6%).
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Válvula Aórtica
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Insuficiencia de la Válvula Aórtica
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Estenosis de la Válvula Aórtica
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Reemplazo de la Válvula Aórtica Transcatéter
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Cardiopatías Congénitas
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Enfermedades de las Válvulas Cardíacas
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Cardiovasc Med (Hagerstown)
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2017
Tipo del documento:
Article