Cardiac Damage Staging in Moderate or Greater Aortic Regurgitation: A New Framework for Risk Stratification

作者：Francisco B. Alexandrino, Ian Persits, Joseph Hajj, Ziad Zalaquett, Velusamy Karthik, Travis Howard, Vincent Chen, Samir Kapadia, Serge C. Harb, Rishi Puri · 发表于：Structural Heart · 年份：2025 · DOI：10.1016/j.shj.2025.100748 · 被引用次数：1 · 研究领域：Cardiac Valve Diseases and Treatments、Aortic Disease and Treatment Approaches、Cardiovascular Function and Risk Factors

Background: Cardiac damage staging is an established prognostic tool in aortic stenosis, and an initial application to aortic regurgitation (AR) showed prognostic relevance, mainly in advanced stages. No dedicated framework currently exists for AR. We aimed to characterize the extent and prognostic implications of multistructural cardiac damage in patients with moderate or greater AR. Methods: We retrospectively analyzed 432 adult patients with ≥ moderate AR who underwent transthoracic echocardiography at Cleveland Clinic between 2008 and 2021. Cardiac damage was staged hierarchically from no damage (stage 0) to right ventricular dysfunction (stage 3) based on echocardiographic assessment of left ventricular (LV) global longitudinal strain, LV ejection fraction, chamber dimensions, valvular abnormalities, pulmonary pressures, and right ventricular function. The primary endpoint was a composite of all-cause mortality and heart failure hospitalization. Results: < 0.0001). Conclusions: In patients with moderate or greater AR, the burden of cardiac damage incrementally stratified long-term risk. A dedicated staging model specific to AR may refine prognostic assessment and support earlier aortic valve interventions.