Staging cardiac damage in patients with aortic regurgitation

• Type: Article in International Scientific Journal
• Date: 2022

Authors

Silva, G (Author) Other; Queiros, P (Author) Other; Silva, M (Author) Other; Saraiva, F (Author) Other; Barros, A (Author) FMUP; Ribeiro, J (Author) Other; Fontes-Carvalho R (Author) FMUP; Sampaio, F (Author) Other

Journal

Title: International Journal of Cardiovascular Imaging

Vol. 38

Pages: 2645-2653

ISSN: 1569-5794

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 4 Citations

Scopus - 6 Citations

Other information

Authenticus ID: P-00W-SQ3

DOI: 10.1007/s10554-022-02673-1

Abstract (EN): The impact of downstream pathophysiological cardiac consequences in aortic regurgitation patients were not well established. The aim of our study was to validate a staging system built for severe aortic stenosis in a large real-world cohort of aortic regurgitation (AR) patients, evaluating the prevalence of different stages of cardiac damage and assess its prognostic impact. Clinical, echocardiographic and outcome data of patients with moderate-severe AR who underwent transthoracic echocardiography between January/2014 and September/2019 were retrospectively analysed. Patients were classified according to the extent of cardiac damage: Stage 0 (no cardiac damage), Stage 1 (left ventricular damage), Stage 2 (mitral valve or left atrial damage), Stage 3 (tricuspid valve or pulmonary artery vasculature damage) and Stage 4 (right ventricular damage). The primary endpoint was all-cause mortality. A total of 571 patients (median age 73, 51% male) were enrolled: Stage 0 (14.0%), Stage 1 (21.5%), Stage 2 (49.2%), Stage 3 (12.3%) and Stage 4 (3.0%). Median follow-up time was 39.5 months (IQR 22.2 to 61.0). At the end of follow-up, cumulative death was significantly higher in more advanced disease stages (log-rank p < 0.001). On multivariable analysis, Stage 3-4 was associated with increased risk of all-cause mortality (HR 3.20; 95% CI 1.48-6.93; p = 0.003). Our study suggests that extra-valvular damage is common in patients with significant AR and that a staging system developed for aortic stenosis also provides prognostic information in these patients. This staging system may be helpful for clinical decision-making regarding the time of valvular intervention. [GRAPHICS] .

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9