Prognostic value of exercise left ventricular end-systolic volume index in patients with asymptomatic aortic regurgitation: an exercise echocardiography study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-11-21

AUTHORS

Yukio Sato, Masaki Izumo, Kengo Suzuki, Seisyou Kou, Kihei Yoneyama, Maya Tsukahara, Kanako Teramoto, Keisuke Minami, Shingo Kuwata, Ryo Kamijima, Kei Mizukoshi, Akio Hayashi, Sachihiko Nobuoka, Eiji Ohtaki, Tomoo Harada, Yoshihiro J. Akashi

ABSTRACT

BackgroundSurgical timing of chronic aortic regurgitation (AR) remains a matter of debate because of limited data. This study assessed the prognostic value of exercise echocardiography in asymptomatic AR.MethodsThis prospective study included 60 consecutive asymptomatic patients with isolated moderate or severe AR (mean regurgitant volume 56.7 ± 11.8 ml) and preserved ejection fraction who underwent exercise echocardiography. The clinical outcomes were defined by the presence of major adverse cardiovascular events (MACE) and the indication for aortic valve replacement (AVR) with class I or IIa classification in the current guidelines.ResultsDuring the average follow-up of 731 days, 12 patients suffered from the clinical events, including two patients developing MACE (3%) and ten patients indicating for AVR (17%). No difference in left ventricular (LV) ejection fraction at rest was found between the patients with and without the clinical events. The indexed LV diameters and LV volumes were significantly dilated in the patients with the clinical events. The Cox proportional hazards regression analysis resulted that the exercise LV end-systolic volume index (LVESVi) was significantly associated with the clinical outcomes [hazard ratio, 1.116; 95% CI (1.032–1.205); p = 0.006]. The Kaplan–Meier analysis showed that exercise LVESVi was clearly stratified the event-free survival.ConclusionsExercise LVESVi might be an independent predictor of prognosis in patients with asymptomatic moderate or severe AR. More... »

PAGES

70-78

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12574-016-0323-3

DOI

http://dx.doi.org/10.1007/s12574-016-0323-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1029794701

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27873174


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    "description": "BackgroundSurgical timing of chronic aortic regurgitation (AR) remains a matter of debate because of limited data. This study assessed the prognostic value of exercise echocardiography in asymptomatic AR.MethodsThis prospective study included 60 consecutive asymptomatic patients with isolated moderate or severe AR (mean regurgitant volume 56.7\u00a0\u00b1\u00a011.8\u00a0ml) and preserved ejection fraction who underwent exercise echocardiography. The clinical outcomes were defined by the presence of major adverse cardiovascular events (MACE) and the indication for aortic valve replacement (AVR) with class I or IIa classification in the current guidelines.ResultsDuring the average follow-up of 731\u00a0days, 12 patients suffered from the clinical events, including two patients developing MACE (3%) and ten patients indicating for AVR (17%). No difference in left ventricular (LV) ejection fraction at rest was found between the patients with and without the clinical events. The indexed LV diameters and LV volumes were significantly dilated in the patients with the clinical events. The Cox proportional hazards regression analysis resulted that the exercise LV end-systolic volume index (LVESVi) was significantly associated with the clinical outcomes [hazard ratio, 1.116; 95% CI (1.032\u20131.205); p\u00a0=\u00a00.006]. The Kaplan\u2013Meier analysis showed that exercise LVESVi was clearly stratified the event-free survival.ConclusionsExercise LVESVi might be an independent predictor of prognosis in patients with asymptomatic moderate or severe AR.", 
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24 schema:description BackgroundSurgical timing of chronic aortic regurgitation (AR) remains a matter of debate because of limited data. This study assessed the prognostic value of exercise echocardiography in asymptomatic AR.MethodsThis prospective study included 60 consecutive asymptomatic patients with isolated moderate or severe AR (mean regurgitant volume 56.7 ± 11.8 ml) and preserved ejection fraction who underwent exercise echocardiography. The clinical outcomes were defined by the presence of major adverse cardiovascular events (MACE) and the indication for aortic valve replacement (AVR) with class I or IIa classification in the current guidelines.ResultsDuring the average follow-up of 731 days, 12 patients suffered from the clinical events, including two patients developing MACE (3%) and ten patients indicating for AVR (17%). No difference in left ventricular (LV) ejection fraction at rest was found between the patients with and without the clinical events. The indexed LV diameters and LV volumes were significantly dilated in the patients with the clinical events. The Cox proportional hazards regression analysis resulted that the exercise LV end-systolic volume index (LVESVi) was significantly associated with the clinical outcomes [hazard ratio, 1.116; 95% CI (1.032–1.205); p = 0.006]. The Kaplan–Meier analysis showed that exercise LVESVi was clearly stratified the event-free survival.ConclusionsExercise LVESVi might be an independent predictor of prognosis in patients with asymptomatic moderate or severe AR.
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31 Kaplan-Meier analysis
32 LV diameter
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34 LV volumes
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39 aortic valve replacement
40 asymptomatic aortic regurgitation
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