Aortic valve prosthesis-patient mismatch and exercise capacity in adult patients with congenital heart disease.

Autor:	van Slooten YJ; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Department of Thoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands., van Melle JP; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Freling HG; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Bouma BJ; Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands., van Dijk AP; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands., Jongbloed MR; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands., Post MC; Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands., Sieswerda GT; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands., Huis In 't Veld A; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Ebels T; Department of Thoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Voors AA; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Pieper PG; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Heart (British Cardiac Society) [Heart] 2016 Jan; Vol. 102 (2), pp. 107-13. Date of Electronic Publication: 2015 Nov 23.
DOI:	10.1136/heartjnl-2015-308013
Abstrakt:	Objectives: To report the prevalence of aortic valve prosthesis-patient mismatch (PPM) in an adult population with congenital heart disease (CHD) and its impact on exercise capacity. Adults with congenital heart disease (ACHD) with a history of aortic valve replacement may outgrow their prosthesis later in life. However, the prevalence and clinical consequences of aortic PPM in ACHD are presently unknown. Methods: From the national Dutch Congenital Corvitia (CONCOR) registry, we identified 207 ACHD with an aortic valve prosthesis for this cross-sectional cohort study. Severe PPM was defined as an indexed effective orifice area ≤0.65 cm2/m2 and moderate PPM as an indexed orifice area ≤0.85 cm2/m2 measured using echocardiography. Exercise capacity was reported as percentage of predicted exercise capacity (PPEC). Results: Of the 207 patients, 68% was male, 71% had a mechanical prosthesis and mean age at inclusion was 43.9 years ±11.4. The prevalence of PPM was 42%, comprising 23% severe PPM and 19% moderate PPM. Prevalence of PPM was higher in patients with mechanical prostheses (p<0.001). PPM was associated with poorer exercise capacity (mean PPEC 84% vs. 92%; p=0.048, mean difference =-8.3%, p=0.047). Mean follow-up was 2.6±1.1 years during which New York Heart Association (NYHA) class remained stable in most patients. PPM showed no significant effect on death or hospitalisation during follow-up (p=0.218). Conclusions: In this study we report a high prevalence (42%) of PPM in ACHD with an aortic valve prosthesis and an independent association of PPM with diminished exercise capacity. (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
Databáze:	MEDLINE
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