Concomitant Mitral Regurgitation in Severe Aortic Stenosis　- Insights From the CURRENT AS Registry-2.

Autor: Obayashi Y; Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University., Takeji Y; Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University.; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences., Taniguchi T; Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital., Morimoto T; Department of Clinical Epidemiology, Hyogo Medical University., Shirai S; Department of Cardiology, Kokura Memorial Hospital., Kitai T; Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital.; Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center., Tabata H; Department of Cardiology, Kokura Memorial Hospital., Ohno N; Division of Cardiovascular Surgery, Kokura Memorial Hospital., Murai R; Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital., Osakada K; Department of Cardiology, Kurashiki Central Hospital., Murata K; Department of Cardiology, Shizuoka City Shizuoka Hospital., Nakai M; Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital., Tsuneyoshi H; Department of Cardiovascular Surgery, Shizuoka General Hospital., Tada T; Department of Cardiology, Shizuoka General Hospital., Amano M; Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center., Watanabe S; Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University., Shiomi H; Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University., Watanabe H; Department of Cardiology, Hirakata Kohsai Hospital., Yoshikawa Y; Department of Biostatistics, National Cerebral and Cardiovascular Center., Nishikawa R; Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University., Yamamoto K; Department of Cardiology, Kokura Memorial Hospital., Toyofuku M; Department of Cardiology, Japanese Red Cross Wakayama Medical Center., Tatsushima S; Department of Cardiology, Japanese Red Cross Wakayama Medical Center., Kanamori N; Division of Cardiology, Shimada General Medical Center., Miyake M; Department of Cardiology, Tenri Hospital., Nakayama H; Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center., Nagao K; Department of Cardiovascular Center, Osaka Red Cross Hospital., Izuhara M; Department of Cardiology, Kishiwada City Hospital., Nakatsuma K; Department of Cardiology, Mitsubishi Kyoto Hospital., Inoko M; Cardiovascular Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital., Fujita T; Department of Cardiology, Japanese Red Cross Wakayama Medical Center., Kimura M; Department of Cardiology, Koto Memorial Hospital., Ishii M; Department of Cardiology, National Hospital Organization Kyoto Medical Center., Usami S; Department of Cardiology, Kansai Electric Power Hospital., Nakazeki F; Department of Cardiology, Japanese Red Cross Otsu Hospital., Togi K; Department of Cardiology, Kindai University Nara Hospital., Inuzuka Y; Department of Cardiology, Shiga General Hospital., Ando K; Department of Cardiology, Kokura Memorial Hospital., Komiya T; Department of Cardiovascular Surgery, Kurashiki Central Hospital., Ono K; Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University., Minatoya K; Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University., Kimura T; Department of Cardiology, Hirakata Kohsai Hospital.
Jazyk: angličtina
Zdroj: Circulation journal : official journal of the Japanese Circulation Society [Circ J] 2024 Nov 25; Vol. 88 (12), pp. 1996-2007. Date of Electronic Publication: 2024 May 09.
DOI: 10.1253/circj.CJ-24-0103
Abstrakt: Background: Data on concomitant mitral regurgitation (MR) in patients with severe aortic stenosis (AS) are scarce.Methods and Results: We investigated the risk of concomitant MR in patients with severe AS in the CURRENT AS Registry-2 according to initial treatment strategy (transcatheter aortic valve implantation [TAVI], surgical aortic valve replacement [SAVR], or conservative). Among 3,365 patients with severe AS, 384 (11.4%) had moderate/severe MR (TAVI: n=126/1,148; SAVR: n=68/591; conservative: n=190/1,626). The cumulative 3-year incidence for death or heart failure (HF) hospitalization was significantly higher in the moderate/severe than no/mild MR group in the entire population (54.6% vs. 34.3%, respectively; P<0.001) and for each treatment strategy (TAVI: 45.0% vs. 31.8% [P=0.006]; SAVR: 31.9% vs. 18.7% [P<0.001]; conservative: 67.8% vs. 41.6% [P<0.001]). The higher adjusted risk of moderate/severe MR relative to no/mild MR for death or HF hospitalization was not significant in the entire population (hazard ratio [HR] 1.15; 95% confidence interval [CI] 0.95-1.39; P=0.15); however, the risk was significant in the SAVR (HR 1.92; 95% CI 1.04-3.56; P=0.04) and conservative (HR 1.30; 95% CI 1.02-1.67; P=0.04) groups, but not in the TAVI group (HR 1.03; 95% CI 0.70-1.52; P=0.86), despite no significant interaction (P interaction =0.37).
Conclusions: Moderate/severe MR was associated with a higher risk for death or HF hospitalization in the initial SAVR and conservative strategies, while the association was less pronounced in the initial TAVI strategy.
Databáze: MEDLINE
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