Determinants and Prognostic Significance of Symptomatic Status in Patients with Moderately Dysfunctional Bicuspid Aortic Valves.
We aimed to identify the clinical and echocardiographic determinants of symptoms and their prognostic implications in patients with moderately dysfunctional bicuspid aortic valves (BAVs).Among 1,019 subjects in the BAV registry treated in a single tertiary care center, the records of 127 patients (8...
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doaj-116ae4680eab4372a3f9348156ddd0982020-11-25T01:49:56ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01121e016928510.1371/journal.pone.0169285Determinants and Prognostic Significance of Symptomatic Status in Patients with Moderately Dysfunctional Bicuspid Aortic Valves.Soo Youn LeeChi Young ShimGeu-Ru HongIn Jeong ChoHyuk-Jae ChangJong-Won HaNamsik ChungWe aimed to identify the clinical and echocardiographic determinants of symptoms and their prognostic implications in patients with moderately dysfunctional bicuspid aortic valves (BAVs).Among 1,019 subjects in the BAV registry treated in a single tertiary care center, the records of 127 patients (85 men, age 58±13 years) with moderately dysfunctional BAVs were comprehensively reviewed. The patients were divided into two groups based on symptom status: asymptomatic (n = 80) vs. symptomatic (n = 47). The primary end-point was defined as a composite of aortic valve surgery, hospitalization for heart failure, and any cause of death.The symptomatic group had a higher proportion of females, hypertension, aortic stenosis, and aortopathy than did the asymptomatic group. The symptomatic group showed lower e' (5.5±1.7 vs. 6.5±2.2 cm/s, p = 0.003), higher E/e' (13.3 ± 4.9 vs. 10.9±3.7, p = 0.002), and larger left atrial volume index (29.9±11.4 vs. 24.6±9.1 ml/m2, p = 0.006) than did the asymptomatic group. In multivariate logistic regression analysis, female gender (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.10-7.36, p = 0.031), hypertension (OR 3.07, 95% CI 1.20-7.82, p = 0.019), moderate aortic stenosis (OR 5.33 5.78, 95% CI 1.99-16.83, p = 0.001), E/e' >15 (OR 3.82, 95% CI 1.03-11.19, p = 0.015), and aortopathy (OR 2.76, 95% CI 1.07-7.10, p = 0.035) were independently correlated with symptom status. The symptomatic group showed a significantly lower rate of event-free survival during the 8-year follow-up period (54±9% vs. 68±10%, p = 0.001).In patients with moderately dysfunctional BAVs, the presence of moderate aortic stenosis, aortopathy, and diastolic dysfunction determines symptom status, along with female gender and hypertension. Symptom status was associated with clinical outcomes.http://europepmc.org/articles/PMC5218394?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Soo Youn Lee Chi Young Shim Geu-Ru Hong In Jeong Cho Hyuk-Jae Chang Jong-Won Ha Namsik Chung |
spellingShingle |
Soo Youn Lee Chi Young Shim Geu-Ru Hong In Jeong Cho Hyuk-Jae Chang Jong-Won Ha Namsik Chung Determinants and Prognostic Significance of Symptomatic Status in Patients with Moderately Dysfunctional Bicuspid Aortic Valves. PLoS ONE |
author_facet |
Soo Youn Lee Chi Young Shim Geu-Ru Hong In Jeong Cho Hyuk-Jae Chang Jong-Won Ha Namsik Chung |
author_sort |
Soo Youn Lee |
title |
Determinants and Prognostic Significance of Symptomatic Status in Patients with Moderately Dysfunctional Bicuspid Aortic Valves. |
title_short |
Determinants and Prognostic Significance of Symptomatic Status in Patients with Moderately Dysfunctional Bicuspid Aortic Valves. |
title_full |
Determinants and Prognostic Significance of Symptomatic Status in Patients with Moderately Dysfunctional Bicuspid Aortic Valves. |
title_fullStr |
Determinants and Prognostic Significance of Symptomatic Status in Patients with Moderately Dysfunctional Bicuspid Aortic Valves. |
title_full_unstemmed |
Determinants and Prognostic Significance of Symptomatic Status in Patients with Moderately Dysfunctional Bicuspid Aortic Valves. |
title_sort |
determinants and prognostic significance of symptomatic status in patients with moderately dysfunctional bicuspid aortic valves. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2017-01-01 |
description |
We aimed to identify the clinical and echocardiographic determinants of symptoms and their prognostic implications in patients with moderately dysfunctional bicuspid aortic valves (BAVs).Among 1,019 subjects in the BAV registry treated in a single tertiary care center, the records of 127 patients (85 men, age 58±13 years) with moderately dysfunctional BAVs were comprehensively reviewed. The patients were divided into two groups based on symptom status: asymptomatic (n = 80) vs. symptomatic (n = 47). The primary end-point was defined as a composite of aortic valve surgery, hospitalization for heart failure, and any cause of death.The symptomatic group had a higher proportion of females, hypertension, aortic stenosis, and aortopathy than did the asymptomatic group. The symptomatic group showed lower e' (5.5±1.7 vs. 6.5±2.2 cm/s, p = 0.003), higher E/e' (13.3 ± 4.9 vs. 10.9±3.7, p = 0.002), and larger left atrial volume index (29.9±11.4 vs. 24.6±9.1 ml/m2, p = 0.006) than did the asymptomatic group. In multivariate logistic regression analysis, female gender (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.10-7.36, p = 0.031), hypertension (OR 3.07, 95% CI 1.20-7.82, p = 0.019), moderate aortic stenosis (OR 5.33 5.78, 95% CI 1.99-16.83, p = 0.001), E/e' >15 (OR 3.82, 95% CI 1.03-11.19, p = 0.015), and aortopathy (OR 2.76, 95% CI 1.07-7.10, p = 0.035) were independently correlated with symptom status. The symptomatic group showed a significantly lower rate of event-free survival during the 8-year follow-up period (54±9% vs. 68±10%, p = 0.001).In patients with moderately dysfunctional BAVs, the presence of moderate aortic stenosis, aortopathy, and diastolic dysfunction determines symptom status, along with female gender and hypertension. Symptom status was associated with clinical outcomes. |
url |
http://europepmc.org/articles/PMC5218394?pdf=render |
work_keys_str_mv |
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