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Staging classification of aortic stenosis based on the extent of cardiac damage

Généreux, Philippe ; Pibarot, Philippe ; Redfors, Björn ; Mack, Michael J ; Makkar, Raj R ; Jaber, Wael A ; Svensson, Lars G ; Kapadia, Samir ; Tuzcu, E Murat ; Thourani, Vinod H ; Babaliaros, Vasilis ; Herrmann, Howard C ; Szeto, Wilson Y ; Cohen, David J ; Lindman, Brian R ; McAndrew, Thomas ; Alu, Maria C ; Douglas, Pamela S ; Hahn, Rebecca T ; Kodali, Susheel K ; Smith, Craig R ; Miller, D Craig ; Webb, John G ; Leon, Martin B

European heart journal, 2017-12, Vol.38 (45), p.3351-3358 [Periódico revisado por pares]

England: Oxford University Press

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Staging classification of aortic stenosis based on the extent of cardiac damage
Autor: Généreux, Philippe ; Pibarot, Philippe ; Redfors, Björn ; Mack, Michael J ; Makkar, Raj R ; Jaber, Wael A ; Svensson, Lars G ; Kapadia, Samir ; Tuzcu, E Murat ; Thourani, Vinod H ; Babaliaros, Vasilis ; Herrmann, Howard C ; Szeto, Wilson Y ; Cohen, David J ; Lindman, Brian R ; McAndrew, Thomas ; Alu, Maria C ; Douglas, Pamela S ; Hahn, Rebecca T ; Kodali, Susheel K ; Smith, Craig R ; Miller, D Craig ; Webb, John G ; Leon, Martin B
Assuntos: Activities of Daily Living ; Aged, 80 and over ; Aortic Valve Stenosis - classification ; Aortic Valve Stenosis - mortality ; Aortic Valve Stenosis - surgery ; Echocardiography ; Editor's Choice ; Fast Track ; Fast Track Clinical Research ; Female ; Humans ; Hypertension, Pulmonary - etiology ; Hypertension, Pulmonary - mortality ; Hypertension, Pulmonary - pathology ; Hypertrophy, Left Ventricular - etiology ; Hypertrophy, Left Ventricular - mortality ; Hypertrophy, Left Ventricular - pathology ; Male ; Prognosis ; Retrospective Studies ; Risk Assessment ; Transcatheter Aortic Valve Replacement - mortality ; Transcatheter Aortic Valve Replacement - statistics & numerical data ; Ventricular Dysfunction, Left - etiology ; Ventricular Dysfunction, Left - mortality ; Ventricular Dysfunction, Left - pathology ; Ventricular Dysfunction, Right - etiology ; Ventricular Dysfunction, Right - mortality ; Ventricular Dysfunction, Right - pathology
É parte de: European heart journal, 2017-12, Vol.38 (45), p.3351-3358
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
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Descrição: In patients with aortic stenosis (AS), risk stratification for aortic valve replacement (AVR) relies mainly on valve-related factors, symptoms and co-morbidities. We sought to evaluate the prognostic impact of a newly-defined staging classification characterizing the extent of extravalvular (extra-aortic valve) cardiac damage among patients with severe AS undergoing AVR. Patients with severe AS from the PARTNER 2 trials were pooled and classified according to the presence or absence of cardiac damage as detected by echocardiography prior to AVR: no extravalvular cardiac damage (Stage 0), left ventricular damage (Stage 1), left atrial or mitral valve damage (Stage 2), pulmonary vasculature or tricuspid valve damage (Stage 3), or right ventricular damage (Stage 4). One-year outcomes were compared using Kaplan-Meier techniques and multivariable Cox proportional hazards models were used to identify 1-year predictors of mortality. In 1661 patients with sufficient echocardiographic data to allow staging, 47 (2.8%) patients were classified as Stage 0, 212 (12.8%) as Stage 1, 844 (50.8%) as Stage 2, 413 (24.9%) as Stage 3, and 145 (8.7%) as Stage 4. One-year mortality was 4.4% in Stage 0, 9.2% in Stage 1, 14.4% in Stage 2, 21.3% in Stage 3, and 24.5% in Stage 4 (Ptrend < 0.0001). The extent of cardiac damage was independently associated with increased mortality after AVR (HR 1.46 per each increment in stage, 95% confidence interval 1.27-1.67, P < 0.0001). This newly described staging classification objectively characterizes the extent of cardiac damage associated with AS and has important prognostic implications for clinical outcomes after AVR.
Editor: England: Oxford University Press
Idioma: Inglês

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Staging classification of aortic stenosis based on the extent of cardiac damage

England: Oxford University Press

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