Implications of Coexisting Aortic Regurgitation in Patients With Aortic Stenosis

作者：Jinghao Nicholas Ngiam, Nicholas Chew, Thanawin Pramotedham, Benjamin Yong‐Qiang Tan, Ching‐Hui Sia, Poay Huan Loh, Wen Ruan, Edgar Lik Wui Tay, William K F Kong, Tiong‐Cheng Yeo, Kian Keong Poh · 发表于：JACC Asia · 年份：2021 · DOI：10.1016/j.jacasi.2021.05.004 · 被引用次数：12 · 研究领域：Cardiac Valve Diseases and Treatments、Aortic Disease and Treatment Approaches、Williams Syndrome Research

Aortic regurgitation (AR) is a common comorbidity in patients with aortic stenosis (AS), but coexisting AR has often been excluded from major clinical studies on AS. The impact of coexisting AR on the natural history of AS has not been well-described. The authors compared clinical outcomes in medically managed patients with moderate-to-severe AS with or without coexisting AR. Consecutive patients (N = 1,188) with index echocardiographic diagnosis of moderate-to-severe AS (aortic valve area <1.5 cm2) were studied. All patients were medically managed and were divided into those with coexisting AR (at least moderate severity) and those without. Adverse composite clinical outcomes were defined as mortality or admissions for congestive cardiac failure on subsequent follow-up. The authors compared differences in clinical profile and outcomes between the groups. There were 88 patients (7.4%) with coexisting AR and AS. These patients did not differ significantly in age, but had lower body mass index (22.9 ± 3.8 vs 25.3 ± 5.1 kg/m2), lower diastolic blood pressure (68.7 ± 10.7 vs 72.2 ± 12.3 mm Hg), larger end-diastolic volume index (68.8 ± 18.8 vs 60.4 ± 17.8 mL/m2) and larger left ventricular mass index (118.6 ± 36.4 vs 108.9 ± 33.1 g/m2). The prevalence of cardiovascular risk factors did not differ significantly. Coexisting AR was associated with increased incidence of adverse outcomes (log-rank 4.20; P = 0.040). On multivariable Cox regression, coexisting AR remained independently...