Characteristics, management, and outcomes of patients with multiple native valvular heart disease a substudy of the EURObservational Research Programme Valvular Heart Disease II Survey /
Aims To assess the characteristics, management, and survival of patients with multiple native valvular heart disease (VHD). Methods and results Among the 5087 patients with >= 1 severe left-sided native VHD included in the EURObservational VHD II Survey (maximum 3-month recruitment period per cen...
Elmentve itt :
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| Dokumentumtípus: | Cikk |
| Megjelent: |
2022
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| Sorozat: | EUROPEAN HEART JOURNAL
43 No. 29 |
| Tárgyszavak: | |
| doi: | 10.1093/eurheartj/ehac209 |
| mtmt: | 32841089 |
| Online Access: | http://publicatio.bibl.u-szeged.hu/26815 |
| Tartalmi kivonat: | Aims To assess the characteristics, management, and survival of patients with multiple native valvular heart disease (VHD). Methods and results Among the 5087 patients with >= 1 severe left-sided native VHD included in the EURObservational VHD II Survey (maximum 3-month recruitment period per centre between January and August 2017 with a 6-month follow-up), 3571 had a single left-sided VHD (Group A, 70.2%), 363 had one severe left-sided VHD with moderate VHD of the other ipsilateral valve (Group B, 7.1%), and 1153 patients (22.7%) had >= 2 severe native VHDs (left-sided and/or tricuspid regurgitation, Group C). Patients with multiple VHD (Groups B and C) were more often women, had greater congestive heart failure (CHF) and comorbidity, higher left atrial volumes and pulmonary pressures, and lower ejection fraction than Group A patients (all P <= 0.01). During the index hospitalization, 36.7% of Group A (n = 1312), 26.7% of Group B (n = 97), and 32.7% of Group C (n = 377) underwent valvular intervention (P < 0.001). Six-month survival was better for Group A than for Group B or C (both P < 0.001), even after adjustment for age, sex, body mass index, and Charlson index [hazard ratio (HR) 95% confidence interval (CI) 1.62 (1.10-2.38) vs. Group B and HR 95% CI 1.72 (1.32-2.25) vs. Group C]. Groups B and C had more CHF at 6 months than Group A (both P < 0.001). Factors associated with mortality in Group C were age, CHF, and comorbidity (all P < 0.010). Conclusion Multiple VHD is common, encountered in nearly 30% of patients with left-sided native VHD, and associated with greater cardiac damage and leads to higher mortality and more heart failure at 6 months than single VHD, yet with lower rates of surgery. |
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| Terjedelem/Fizikai jellemzők: | 2756-2766 |
| ISSN: | 0195-668X |