Outcomes of patients with early calcific aortic valve disease detected by clinically indicated echocardiography.

Autor:	Moore MK; Department of Medicine, HeartOtago, Dunedin School of Medicine, University of Otago, PO Box 9056, Dunedin 9054, New Zealand., Jones GT; Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand., Whalley G; Department of Medicine, HeartOtago, Dunedin School of Medicine, University of Otago, PO Box 9056, Dunedin 9054, New Zealand., Prendergast B; St Thomas' Hospital and Cleveland Clinic London, UK., Williams MJA; Department of Medicine, HeartOtago, Dunedin School of Medicine, University of Otago, PO Box 9056, Dunedin 9054, New Zealand.; Department of Cardiology, Dunedin Hospital, Te Whatu Ora Southern, 201 Great King Street, Dunedin 9016, New Zealand., Coffey S; Department of Medicine, HeartOtago, Dunedin School of Medicine, University of Otago, PO Box 9056, Dunedin 9054, New Zealand.; Department of Cardiology, Dunedin Hospital, Te Whatu Ora Southern, 201 Great King Street, Dunedin 9016, New Zealand.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2024 Feb 22; Vol. 25 (3), pp. 356-364.
DOI:	10.1093/ehjci/jead259
Abstrakt:	Aims: Previous studies have demonstrated relatively slow rates of progression of early calcific aortic valve disease (CAVD), which encompasses aortic sclerosis (ASc) and mild aortic stenosis (AS). The potential evolution to clinically significant AS is unclear, and we therefore examined the long-term outcomes of patients with ASc and mild AS detected at the time of clinically indicated echocardiography. Methods and Results: Data from initial clinically indicated echocardiograms performed between 2010 and 2018 in patients aged ≥18 years were extracted and linked to nationally collected outcome data. Those with impaired right or left systolic ventricular function or other significant left-sided valve disease were excluded. A time to first event analysis was performed with a composite primary outcome of cardiovascular death and aortic valve intervention (AVI). Of the 13 313 patients, 8973 had no CAVD, 3436 had ASc, and 455 had mild AS. The remainder had moderate or worse stenosis. Over a median follow-up period of 4.2 (interquartile range 1.8-6.7) years (and after adjustment for age and sex), those with ASc were at greater risk of the primary outcome [hazard ratio (HR) 2.9, 95% confidence interval (CI) 2.1-4.0] and need for AVI (HR 26.8, 95% CI 9.1-79.1) compared with those with no CAVD. Clinical event rates accelerated after ∼5 years in those with mild AS. Conclusion: Patients with ASc are >25 times more likely to require AVI than those with no CAVD, and follow-up echocardiography should be considered within 3-4 years in those with mild AS. Competing Interests: Conflict of interest: None declared. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu