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  • Showing results for impact of mean transaortic pressure gradient on long-term outcome in patients with severe aortic stenosis and preserved left ventricular ejection fraction. Your search for mpact of Mean Transaortic Pressure Gradient on Long-Term Outcome in Patients With Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction retrieved no results.
J Am Heart Assoc. 2017 Jun 1;6(6). pii: e005850. doi: 10.1161/JAHA.117.005850.

Impact of Mean Transaortic Pressure Gradient on Long-Term Outcome in Patients With Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction.

Author information

1
Department of Cardiology, Amiens University Hospital, Amiens, France.
2
INSERM U-1088, Jules Verne University of Picardie, Amiens, France.
3
Groupement des Hôpitaux de l'Institut Catholique de Lille/Faculté libre de médecine, Université Lille Nord de France, Lille, France.
4
Department of Cardiology, Amiens University Hospital, Amiens, France tribouilloy.christophe@chu-amiens.fr.

Abstract

BACKGROUND:

Mean transaortic pressure gradient (MTPG) has never been validated as a predictor of mortality in patients with severe aortic stenosis. We sought to determine the value of MTPG to predict mortality in a large prospective cohort of severe aortic stenosis patients with preserved left ventricular ejection fraction and to investigate the cutoff of 60 mm Hg, proposed in American guidelines.

METHODS AND RESULTS:

A total of 1143 patients with severe aortic stenosis defined by aortic valve area ≤1 cm2 and MTPG ≥40 mm Hg were included. The population was divided into 3 groups according to MTPG: between 40 and 49 mm Hg, between 50 and 59 mm Hg, and ≥60 mm Hg. The end point was all-cause mortality. MTPG was ≥60 mm Hg in 392 patients. Patients with MTPG ≥60 mm Hg had a significantly increase risk of mortality compared with patients with MTPG <60 mm Hg (hazard ratio [HR]=1.62 [1.27-2.05] P<0.001), even for the subgroup of asymptomatic or minimally symptomatic patients (HR=1.56 [1.04-2.34] P=0.032). After adjustment for established outcome predictors, patients with MTPG ≥60 mm Hg had a significantly higher risk of mortality than patients with MTPG <60 mm Hg (HR=1.71 [1.33-2.20] P<0.001), even after adjusting for surgery as a time-dependent variable (HR=1.71 [1.43-2.11] P<0.001). Similar results were observed for the subgroup of asymptomatic or minimally symptomatic patients (HR=1.70 [1.10-2.32] P=0.018 and HR=1.68 [1.20-2.36] P=0.003, respectively).

CONCLUSIONS:

This study shows the negative prognostic impact of high MTPG (≥60 mm Hg), on long-term outcome of patients with severe aortic stenosis with preserved left ventricular ejection fraction, irrespective of symptoms.

KEYWORDS:

asymptomatic and minimally symptomatic patients; mean transaortic pressure gradient; mortality; prognosis; severe aortic stenosis

PMID:
28572283
PMCID:
PMC5669186
DOI:
10.1161/JAHA.117.005850
[Indexed for MEDLINE]
Free PMC Article

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