Aortic valve stenosis in community medical practice: Determinants of outcome and implications for aortic valve replacement
| Autor: | Hartzell V. Schaff, Thierry Le Tourneau, Maurice Enriquez-Sarano, Joseph Malouf, Thoralf M. Sundt, Christopher G. Scott, Patricia A. Pellikka |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors Minnesota Kaplan-Meier Estimate Risk Assessment Severity of Illness Index Aortic valve replacement Predictive Value of Tests Risk Factors Internal medicine Severity of illness medicine Humans Community Health Services Aged Proportional Hazards Models Retrospective Studies Aged 80 and over Heart Valve Prosthesis Implantation Chi-Square Distribution Ejection fraction business.industry Patient Selection Aortic Valve Stenosis Middle Aged medicine.disease Echocardiography Doppler Surgery Cardiac surgery Stenosis Treatment Outcome Aortic Valve Heart failure Relative risk Aortic valve stenosis Multivariate Analysis Practice Guidelines as Topic Cardiology Female Guideline Adherence business Cardiology and Cardiovascular Medicine |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 144(6):1421-1427 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2011.09.075 |
| Popis: | ObjectiveTo define the objective and subjective measures of aortic stenosis (AS) severity linked to survival after diagnosis in community practice.MethodsAll 360 Olmsted County, Minnesota residents (74 ± 14 years; 44% men) with AS diagnosed from 1988 to 1997 by echocardiography and without life-threatening comorbid conditions were enrolled. The presentation at first diagnosis, outcomes (mortality, heart failure, cardiac surgery), and coherence of guideline-based criteria for severe AS were analyzed.ResultsThe presentation was challenging. Cardiac symptoms were frequent (59%) and unassociated with the AS severity (all P > .13). Of the patients with severe AS, as determined by a valve area less than 1.0 cm2, 67% had low gradient AS (≤40 mm Hg). An aortic valve area less than 1.0 cm2 was the only objective measure independently determining survival (adjusted risk ratio, 1.81; 95% confidence interval [CI], 1.19–2.70; P |
| Databáze: | OpenAIRE |
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