Clinical and echocardiographic predictors of decompensation in acute severe aortic regurgitation due to infective endocarditis
| Autor: | Kit Wong, Kamatamu A Mbonye, Guy Lloyd, Sanjeev Bhattacharyya, Simon Woldman, Omotomilola Bajomo, Christopher Primus, Lewis Ceri Davies, Athina Chasapi, Mohammed Y Khanji, William J Young, Shirish Ambekar, Rakesh Uppal |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Aortic Valve Insufficiency Diastole Hemodynamics 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Mitral valve Internal medicine medicine Clinical endpoint Humans Radiology Nuclear Medicine and imaging Decompensation 030212 general & internal medicine Mitral regurgitation business.industry Cardiogenic shock Mitral Valve Insufficiency Endocarditis Bacterial medicine.disease medicine.anatomical_structure Blood pressure Echocardiography Cardiology Mitral Valve Cardiology and Cardiovascular Medicine business |
| Zdroj: | Echocardiography. 38:590-595 |
| ISSN: | 1540-8175 0742-2822 |
| DOI: | 10.1111/echo.15028 |
| Popis: | BACKGROUND Patients with acute severe aortic regurgitation (AR) due to infective endocarditis can progress rapidly from the hemodynamically stable patient to pulmonary edema and cardiogenic shock. We sought to identify patients at risk of decompensation where emergent surgery should be undertaken. METHODS We identified 90 patients with acute severe AR from the echocardiography laboratory database. Baseline clinical, hemodynamic (heart rate (HR) and blood pressure (BP)), and echocardiographic data including mitral filling, premature mitral valve closure (PMVC), and diastolic mitral regurgitation (DMR) were identified. The primary endpoint was subsequent development of pulmonary edema or severe hemodynamic instability. RESULTS Patients who met the primary endpoint had a higher HR (98.5 bpm vs 80.5 bpm), lower diastolic BP (54 mm Hg vs 61.5 mm Hg), higher mitral E-wave velocity (113 cm/s vs 83 cm/s), higher E/e' ratio (12.4 vs 8), higher proportion of DMR (27.8% vs 7.4%), and PMVC (25% vs 9.3%) than patients who did not meet the endpoint. The proportion of patients with the primary endpoint increased as HR increased ((≤81 bpm) 3/30 (10%), (81-94 bpm) 11/31 (35.5%), (≥94 bpm) 22/29 (75.9%), P |
| Databáze: | OpenAIRE |
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