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http://hdl.handle.net/1942/36006
Title: | Mild aortic valve disease and the diastolic pressure–volume relationship in heart failure with preserved ejection fraction | Authors: | VERBRUGGE, Frederik Reddy, YNV Eleid, MF Lin, G. Burkhoff, D Borlaug, BA |
Issue Date: | 2021 | Publisher: | BMJ PUBLISHING GROUP | Source: | Open Heart, 8 (2) , (Art N° e001701) | Abstract: | Objective Mild aortic valve stenosis (AS) and aortic valve (AV) sclerosis are associated with diastolic dysfunction and increased mortality in the general population. This study specifically investigated the impact of mild AV disease in heart failure with preserved ejection fraction (HFpEF). Methods Consecutive patients hospitalised with HFpEF (n=370) underwent assessment of cardiac structure and function and long-term clinical follow-up. Results In the study cohort, 111 had mild AS (30%), 104 AV sclerosis (28%) and 155 a non-calcified AV (42%). Mild-to-moderate AV regurgitation (AR) was present in 64 (17%). Compared with patients with a normal AV, those with AV disease were older, with worse renal function and more atrial fibrillation. E/e ' increased from non-calcified AV to AV sclerosis to mild AS (13.8 (10.8-16.8) vs 15.0 (10.9-20.0) vs 18.0 (12.7-23.3), respectively; p<0.001)). Left ventricular diastolic pressure-volume relationships were shifted leftwards in patients with AS and AV sclerosis, but not influenced by AR. The left ventricular end-diastolic volume normalised at 20 mm Hg was 117 +/- 34 mL, 106 +/- 30 mL and 112 +/- 30 mL in non-calcified AV, AV sclerosis and mild AS, respectively (p=0.023), while 112 +/- 32 mL in mild-to-moderate AR. Over 30 months (IQR, 8-61 months), 247 patients died (67%). The presence of mild AV disease was associated with increased mortality, but this was no longer significant after adjusting for age and sex. Conclusions Low-grade AV disease is common among patients hospitalised for HFpEF and is associated with older age, atrial arrhythmia, renal dysfunction, higher left heart filling pressures and increased left ventricular chamber stiffness. | Notes: | Borlaug, BA (corresponding author), Mayo Clin, Dept Cardiovasc Dis, Rochester, MN 55905 USA. borlaug.barry@mayo.edu |
Keywords: | echocardiography;aortic valve stenosis;aortic valve insufficiency;heart failure;diastolic | Document URI: | http://hdl.handle.net/1942/36006 | ISSN: | 2053-3624 | e-ISSN: | 2053-3624 | DOI: | 10.1136/openhrt-2021-001701 | ISI #: | WOS:000709893300001 | Rights: | Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. | Category: | A1 | Type: | Journal Contribution | Validations: | vabb 2023 |
Appears in Collections: | Research publications |
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e001701.full.pdf | Published version | 1.44 MB | Adobe PDF | View/Open |
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