Risk of supranormal left ventricular ejection fraction in patients with aortic stenosis

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2024-03-12 DOI:10.1002/clc.24255

Naoya Inoue MD, Hayato Ohtani PhD, Shuji Morikawa MD, Yohei Takayama MD, Takashi Ogane MD, Takehiro Hiramatsu MD, Hiroki Kumihashi MD, Toyoaki Murohara PhD

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引用次数: 0

Abstract

Background

Cardiovascular events are increasing in patients with supranormal left ventricular ejection fraction (snLVEF). However, the effect of snLVEF in patients with aortic stenosis (AS) remains unclear, especially in patients with moderate AS.

Hypothesis

This study aimed to evaluate the prognosis of mortality and heart failure (HF) in patients with LVEF ≥ 50% and moderate or severe AS.

Methods

This retrospective study targeted patients with moderate or severe AS and LVEF > 50%. LVEF of 50%–65% was classified as normal LVEF (nLVEF, nEF group) and >65% as snLVEF (snEF group). AS severity was stratified based on the aortic valve area into moderate (1.0–1.5 cm²) and severe (<1.0 cm²). Primary outcomes included all-cause mortality and HF hospitalization.

Results

A total of 226 participants were included in this study. There were 67 and 65 participants with moderate AS in snEF (m-snEF) and nEF groups (m-nEF), respectively, and 41 and 53 participants with severe AS in the snEF (s-snEF) and nEF groups (s-nEF), respectively. During the observation period (median: 554 days), the primary composite outcome occurred in 108 individuals. Cox hazard analysis revealed no significant differences among the four groups in primary composite outcomes. With respect to HF hospitalization, the adjusted hazard ratios (95% confidence intervals) with m-snEF as the reference were as follows: m-nEF, 0.41 (0.19–0.89); s-nEF, 1.43 (0.76–2.67); and s-snEF, 1.83 (1.00–3.35).

Conclusions

The risk of HF hospitalization for m-snLVEF was higher than m-nLVEF and not significantly different from s-nLVEF.

Abstract Image

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主动脉瓣狭窄患者左心室射血分数超常的风险。

背景：左心室射血分数超常（snLVEF）患者的心血管事件正在增加。然而，snLVEF 对主动脉瓣狭窄（AS）患者，尤其是中度 AS 患者的影响仍不明确：本研究旨在评估 LVEF ≥ 50%、中度或重度 AS 患者的死亡率和心力衰竭（HF）的预后：这项回顾性研究的对象是LVEF>50%的中度或重度强直性脊柱炎患者。LVEF在50%-65%的患者被划分为正常LVEF（nLVEF，nEF组），大于65%的患者被划分为snLVEF（snEF组）。强直性脊柱炎的严重程度根据主动脉瓣面积分为中度（1.0-1.5 平方厘米）和重度（结果：本研究共纳入 226 名参与者。在snEF（m-snEF）和nEF（m-nEF）组中，分别有67名和65名中度AS患者；在snEF（s-snEF）和nEF（s-nEF）组中，分别有41名和53名重度AS患者。在观察期间（中位数：554 天），108 人出现了主要综合结果。Cox 危险分析显示，四组患者的主要综合结果无显著差异。关于心房颤动住院，以 m-snEF 为参照的调整后危险比（95% 置信区间）如下：m-nEF，0.41（0.19-0.89）；s-nEF，1.43（0.76-2.67）；s-snEF，1.83（1.00-3.35）：结论：m-snLVEF的HF住院风险高于m-nLVEF，但与s-nLVEF无显著差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.