Non-severe aortic regurgitation increases short-term mortality in acute heart failure with preserved ejection fraction.

Details

Serval ID
serval:BIB_77380AB53612
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Non-severe aortic regurgitation increases short-term mortality in acute heart failure with preserved ejection fraction.
Journal
ESC heart failure
Author(s)
Abdurashidova T., Monney P., Tzimas G., Soborun N., Regamey J., Daux A., Barras N., Kirsch M., Müller M., Hullin R.
ISSN
2055-5822 (Electronic)
ISSN-L
2055-5822
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Mild or moderate aortic regurgitation (AR) has only little effect on cardiovascular outcome in people with normal left ventricular ejection fraction (EF); therefore, it is not perceived as a major clinical problem. This study investigates whether mild or moderate AR is associated with increased short-term mortality in patients hospitalized for treatment of acute heart failure (AHF) and whether mild or moderate AR impacts differently on short-term mortality in AHF patients with reduced EF (AHFrEF), mid-range EF (AHFmrEF), or preserved EF (AHFpEF).
This mono-centric study included 505 consecutive adult patients hospitalized for de novo or worsening chronic HF not related to acute ischaemia or severe valvular pathology in the echocardiogram at index hospitalization. Cox regression analysis studied the impact of AR on all-cause mortality (ACM) over the 150 days' study period. Mild or moderate AR was associated with increased ACM (HR 1.75 [95% CI: 1.1-2.7]; P = 0.009). The prevalence of mild or moderate AR in the study population was 42% and not significantly different between AHFpEF (n = 227), AHFmrEF (n = 86), and AHFrEF (n = 192) study participants (37.9% vs. 50.0% vs. 42.7%; P = 0.144). In AHFpEF patients, the age-adjusted hazard for ACM was increased in patients with AR compared with patients without AR (HR 2.17 [95% CI: 1.1-4.2]; P = 0.002). The age-adjusted hazard for ACM was increased by a trend in AHFmrEF with AR (HR 7.11, [95% CI: 0.9-57.8]; P = 0.067) and not different between the AHFrEF groups (HR 0.95 [95% CI: 0.5-1.8]; P = 0.875).
Mild or moderate AR increased ACM only in AHFpEF patients, highlighting a distinct clinical relevance.
Keywords
Acute heart failure, All-cause mortality, Aortic regurgitation
Pubmed
Web of science
Open Access
Yes
Create date
09/10/2020 11:16
Last modification date
26/11/2020 6:26
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