Long-term outcomes in patients with aortic regurgitation in the Zagreb University Hospital Centre

    Authors

    Keywords

    aortic regurgitation, aortic valve replacement, outcomes

    DOI

    https://doi.org/10.15836/ccar2019.226

    Full Text

    Introduction : Age and gender may influence the incidence of aortic regurgitation (AR) and its severity. Significant aortic regurgitation (sAR) is often treated surgically especially when symptomatic or when systolic function declines. ( 1 ) The aim of this study was to evaluate the outcomes in patients with sAR according to treatment strategy, age and gender differences in our study population. Patients and Methods : In this retrospective descriptive single-centre study an overall of 107 patients (22 female, 85 male) with significant AR in the last 5 years were analyzed. Patients were treated according to valid recommendations, surgically (SUR) or conservatively (CON), except for 5 patients who refused surgery. Baseline and follow up (FU) data (AR severity, left ventricle ejection fraction (LVEF), ascending aorta diameter (AA), treatment, comorbidities and major adverse cardiovascular events (MACE) during FU), from documented medical history and digital imaging data were collected and analysed. Additional sub-analysis was performed according to sex and age differences (above vs. below the age of 50). For statistical analysis a Chi-Square test was used. Results : In the overall study population, during an average FU of 3.8 years, 16 patients (15%) developed MACE with no statistically significant difference between gender (p=0.846). Forty-six (43%) patients were surgically treated (87% male, 13% female) and 61 (54%) conservatively. LVEF did not worsen in FU period (54.1%, vs. 53.8%). In SUR, median age was 54 years, severe AR was present in 93%, incidence of MACE was 21.7%, 80.4% patients were symptomatic and 14.5% had dilatation of AA more than 50 mm. In CON, MACE was present in 9.8% during FU (p=0.87), median age was 64 years. Moderate AR (48% vs 6.5%) and AA from 40-49 mm (80 vs 35%) was present more frequently as well as arterial hypertension (82 vs 70%) and chronic renal disease (23.2 vs 16.6%). The incidence of MACE was not found to be age-related (p=0.426). Conclusion : In patients with sAR treated by either surgery or medication therapy only, during 3.8 years of FU, LVEF remained unchanged, while incidence of MACE was not found to be related to treatment strategy nor gender. In surgically treated patients, as expected, AR was more severe and AA was more dilated, while neither age nor gender had an impact on the incidence of MACE.

    Cardiologia Croatica
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    Long-term outcomes in patients with aortic regurgitation in the Zagreb University Hospital Centre

    Extended Abstract
    Issue9-10
    Published
    Pages226
    PDF via DOIhttps://doi.org/10.15836/ccar2019.226
    aortic regurgitation
    aortic valve replacement
    outcomes

    Authors

    Marija Mance*ORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Vlatka Rešković LukšićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Ivan BitunjacORCIDCroatia
    Blanka Glavaš KonjaORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Martina Lovrić BenčićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Joško BulumORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Zvonimir OstojićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Dubravka ŠipušORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Jadranka Šeparović HanževačkiORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia

    Full Text

    Introduction : Age and gender may influence the incidence of aortic regurgitation (AR) and its severity. Significant aortic regurgitation (sAR) is often treated surgically especially when symptomatic or when systolic function declines. ( 1 ) The aim of this study was to evaluate the outcomes in patients with sAR according to treatment strategy, age and gender differences in our study population. Patients and Methods : In this retrospective descriptive single-centre study an overall of 107 patients (22 female, 85 male) with significant AR in the last 5 years were analyzed. Patients were treated according to valid recommendations, surgically (SUR) or conservatively (CON), except for 5 patients who refused surgery. Baseline and follow up (FU) data (AR severity, left ventricle ejection fraction (LVEF), ascending aorta diameter (AA), treatment, comorbidities and major adverse cardiovascular events (MACE) during FU), from documented medical history and digital imaging data were collected and analysed. Additional sub-analysis was performed according to sex and age differences (above vs. below the age of 50). For statistical analysis a Chi-Square test was used. Results : In the overall study population, during an average FU of 3.8 years, 16 patients (15%) developed MACE with no statistically significant difference between gender (p=0.846). Forty-six (43%) patients were surgically treated (87% male, 13% female) and 61 (54%) conservatively. LVEF did not worsen in FU period (54.1%, vs. 53.8%). In SUR, median age was 54 years, severe AR was present in 93%, incidence of MACE was 21.7%, 80.4% patients were symptomatic and 14.5% had dilatation of AA more than 50 mm. In CON, MACE was present in 9.8% during FU (p=0.87), median age was 64 years. Moderate AR (48% vs 6.5%) and AA from 40-49 mm (80 vs 35%) was present more frequently as well as arterial hypertension (82 vs 70%) and chronic renal disease (23.2 vs 16.6%). The incidence of MACE was not found to be age-related (p=0.426). Conclusion : In patients with sAR treated by either surgery or medication therapy only, during 3.8 years of FU, LVEF remained unchanged, while incidence of MACE was not found to be related to treatment strategy nor gender. In surgically treated patients, as expected, AR was more severe and AA was more dilated, while neither age nor gender had an impact on the incidence of MACE.