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首页> 外文期刊>Cardiology >The Association between Aortic Valve Weight, Echocardiographic Indices, and All-Cause Death in 1,046 Patients Undergoing Surgical Aortic Valve Replacement for Aortic Stenosis
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The Association between Aortic Valve Weight, Echocardiographic Indices, and All-Cause Death in 1,046 Patients Undergoing Surgical Aortic Valve Replacement for Aortic Stenosis

机译：在1,046名患者中，主动脉瓣重量，超声心动图索引和全因死亡术治疗主动脉瓣膜狭窄的手术主动脉瓣膜

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Background: Aortic valve weight (AVW), a flow independent measure of aortic stenosis (AS) severity, is reported to have heterogeneous associations with the echocardiographic variables used for AS evaluation. Controversy exists regarding its impact on survival after aortic valve replacement (AVR). Objective: We sought to determine the association between AVW with echocardiographic measures of AS severity and all-cause mortality after surgical AVR. Methods: One thousand and forty-sixconsecutive patients underwent surgical AVR for AS, the excised valves were weighed, and an echocardiogram was done before surgery. Results: Males had heavier valves than females, for both absolute and body surface are (BSA)-indexed values (2.78 +/- 1.23 vs. 2.08 +/- 0.68 g, p < 0.001; and 1.38 +/- 0.61 vs. 1.19 +/- 0.41 g/m(2), p < 0.001, respectively). In a restricted cohort of 634 patients with isolated severe AS and normal ejection fraction, the correlations of AVW with echocardiographic variables of AS were modest, the strongest being with the dimensionless index (r = -0.27 and -0.26 for male and female, both p < 0.01). Stratified by stroke volume index and mean gradient (MG), no associations were found in the low-gradient groups (i.e., MG Hg). At a median follow-up of 3.5 years, there were only 244 deaths in the entire cohort. Mortality was not related to AVW, except in females who displayed an inverse relationship (HR = 0.67; 95% CI 0.47-0.95) only when it was analyzed as a continuous variable. Conclusions: The weak correlation between AVW with the echocardiographic indices of AS may reflect its complex pathophysiology, heterogeneous hemodynamics, and possible pitfalls in the current echocardiographic methods used in clinical practice. The prognostic value of AVW after AVR warrants further evaluation.
机译：背景：主动脉瓣重量（AVW），据报道，主动脉狭窄（AS）严重程度的流动独立度量，与用于评估的超声心动图变量具有异质关联。存在对主动脉瓣更换（AVR）后对存活的影响存在争议。目的：我们试图确定AVW与外科AVR后严重程度和全因死亡率的超声心动图措施的关联。方法：千分之二六六六患者进行外科AVR，称重切除阀，手术前进行超声心动图。结果：雄性比雌性更重阀门，对于绝对和体表（BSA） - 低价值（2.78 +/- 1.23，2.08 +/- 0.68g，P <0.001;和1.38 +/- 0.61与1.19 +/- 0.41g / m（2），p <0.001分别）。在634名患者的抑制群体中分离出严重和正常的喷射分数，AVW与超声心动图变量的相关性谦虚，最强大的是具有无量纲指数的（r = -0.27和-0.26，男性和女性的r = -0.27和-0.26，都是p <0.01）。通过中风体积指数和平均梯度（Mg）分层，在低梯度基团（即Mg Hg）中没有发现任何关联。在3.5岁的中位随访，整个队列中只有244人死亡。除了展示反比关系的女性之外，死亡率与AVW不同，只有当分析为连续变量时才显示反向关系的女性（HR = 0.67; 95％CI 0.47-0.95）。结论：AVW与超声心动图索引之间的弱相关性反映其在临床实践中使用的目前超声心动图的复杂病理学，异质血流动力学和可能的缺陷。 AVR后AVW的预后价值进一步评估。

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