Determinants and prognostic significance of symptomatic status in patients with moderately dysfunctional bicuspid aortic valves

Youn Lee Soo, ChiYoung Shim, Hong Geu-Ru, Jeong Cho In, Hyuk-Jae Chang, Won Ha Jong, Chung Namsik

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background We aimed to identify the clinical and echocardiographic determinants of symptoms and their prognostic implications in patients with moderately dysfunctional bicuspid aortic valves (BAVs). Methods Among 1,019 subjects in the BAV registry treated in a single tertiary care center, the records of 127 patients (85 men, age 58±13 years) with moderately dysfunctional BAVs were comprehensively reviewed. The patients were divided into two groups based on symptom status: asymptomatic (n = 80) vs. symptomatic (n = 47). The primary end-point was defined as a composite of aortic valve surgery, hospitalization for heart failure, and any cause of death. Results The symptomatic group had a higher proportion of females, hypertension, aortic stenosis, and aortopathy than did the asymptomatic group. The symptomatic group showed lower e0 (5.5±1.7 vs. 6.5±2.2 cm/s, p = 0.003), higher E/e0 (13.3 ± 4.9 vs. 10.9±3.7, p = 0.002), and larger left atrial volume index (29.9±11.4 vs. 24.6±9.1 ml/m2 , p = 0.006) than did the asymptomatic group. In multivariate logistic regression analysis, female gender (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.10-7.36, p = 0.031), hypertension (OR 3.07, 95% CI 1.20-7.82, p = 0.019), moderate aortic stenosis (OR 5.33 5.78, 95% CI 1.99-16.83, p = 0.001), E/e0 >15 (OR 3.82, 95% CI 1.03-11.19, p = 0.015), and aortopathy (OR 2.76, 95% CI 1.07-7.10, p = 0.035) were independently correlated with symptom status. The symptomatic group showed a significantly lower rate of event-free survival during the 8-year follow-up period (54±9% vs. 68±10%, p = 0.001).Conclusions In patients with moderately dysfunctional BAVs, the presence of moderate aortic stenosis, aortopathy, and diastolic dysfunction determines symptom status, along with female gender and hypertension. Symptom status was associated with clinical outcomes.

Original languageEnglish
Article numbere0169285.
JournalPLoS One
Volume12
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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Regression analysis
odds ratio
Surgery
signs and symptoms (animals and humans)
Logistics
confidence interval
Odds Ratio
Confidence Intervals
Aortic Valve Stenosis
hypertension
Composite materials
Hypertension
gender
heart failure
Aortic Valve
Tertiary Care Centers
Disease-Free Survival
Registries
Cause of Death
Hospitalization

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

@article{1dcee9d8c9d543d1a3c895b39f9fb310,
title = "Determinants and prognostic significance of symptomatic status in patients with moderately dysfunctional bicuspid aortic valves",
abstract = "Background We aimed to identify the clinical and echocardiographic determinants of symptoms and their prognostic implications in patients with moderately dysfunctional bicuspid aortic valves (BAVs). Methods Among 1,019 subjects in the BAV registry treated in a single tertiary care center, the records of 127 patients (85 men, age 58±13 years) with moderately dysfunctional BAVs were comprehensively reviewed. The patients were divided into two groups based on symptom status: asymptomatic (n = 80) vs. symptomatic (n = 47). The primary end-point was defined as a composite of aortic valve surgery, hospitalization for heart failure, and any cause of death. Results The symptomatic group had a higher proportion of females, hypertension, aortic stenosis, and aortopathy than did the asymptomatic group. The symptomatic group showed lower e0 (5.5±1.7 vs. 6.5±2.2 cm/s, p = 0.003), higher E/e0 (13.3 ± 4.9 vs. 10.9±3.7, p = 0.002), and larger left atrial volume index (29.9±11.4 vs. 24.6±9.1 ml/m2 , p = 0.006) than did the asymptomatic group. In multivariate logistic regression analysis, female gender (odds ratio [OR] 2.84, 95{\%} confidence interval [CI] 1.10-7.36, p = 0.031), hypertension (OR 3.07, 95{\%} CI 1.20-7.82, p = 0.019), moderate aortic stenosis (OR 5.33 5.78, 95{\%} CI 1.99-16.83, p = 0.001), E/e0 >15 (OR 3.82, 95{\%} CI 1.03-11.19, p = 0.015), and aortopathy (OR 2.76, 95{\%} CI 1.07-7.10, p = 0.035) were independently correlated with symptom status. The symptomatic group showed a significantly lower rate of event-free survival during the 8-year follow-up period (54±9{\%} vs. 68±10{\%}, p = 0.001).Conclusions In patients with moderately dysfunctional BAVs, the presence of moderate aortic stenosis, aortopathy, and diastolic dysfunction determines symptom status, along with female gender and hypertension. Symptom status was associated with clinical outcomes.",
author = "Soo, {Youn Lee} and ChiYoung Shim and Hong Geu-Ru and In, {Jeong Cho} and Hyuk-Jae Chang and Jong, {Won Ha} and Chung Namsik",
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Determinants and prognostic significance of symptomatic status in patients with moderately dysfunctional bicuspid aortic valves. / Soo, Youn Lee; Shim, ChiYoung; Geu-Ru, Hong; In, Jeong Cho; Chang, Hyuk-Jae; Jong, Won Ha; Namsik, Chung.

In: PLoS One, Vol. 12, No. 1, e0169285., 01.01.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Determinants and prognostic significance of symptomatic status in patients with moderately dysfunctional bicuspid aortic valves

AU - Soo, Youn Lee

AU - Shim, ChiYoung

AU - Geu-Ru, Hong

AU - In, Jeong Cho

AU - Chang, Hyuk-Jae

AU - Jong, Won Ha

AU - Namsik, Chung

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background We aimed to identify the clinical and echocardiographic determinants of symptoms and their prognostic implications in patients with moderately dysfunctional bicuspid aortic valves (BAVs). Methods Among 1,019 subjects in the BAV registry treated in a single tertiary care center, the records of 127 patients (85 men, age 58±13 years) with moderately dysfunctional BAVs were comprehensively reviewed. The patients were divided into two groups based on symptom status: asymptomatic (n = 80) vs. symptomatic (n = 47). The primary end-point was defined as a composite of aortic valve surgery, hospitalization for heart failure, and any cause of death. Results The symptomatic group had a higher proportion of females, hypertension, aortic stenosis, and aortopathy than did the asymptomatic group. The symptomatic group showed lower e0 (5.5±1.7 vs. 6.5±2.2 cm/s, p = 0.003), higher E/e0 (13.3 ± 4.9 vs. 10.9±3.7, p = 0.002), and larger left atrial volume index (29.9±11.4 vs. 24.6±9.1 ml/m2 , p = 0.006) than did the asymptomatic group. In multivariate logistic regression analysis, female gender (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.10-7.36, p = 0.031), hypertension (OR 3.07, 95% CI 1.20-7.82, p = 0.019), moderate aortic stenosis (OR 5.33 5.78, 95% CI 1.99-16.83, p = 0.001), E/e0 >15 (OR 3.82, 95% CI 1.03-11.19, p = 0.015), and aortopathy (OR 2.76, 95% CI 1.07-7.10, p = 0.035) were independently correlated with symptom status. The symptomatic group showed a significantly lower rate of event-free survival during the 8-year follow-up period (54±9% vs. 68±10%, p = 0.001).Conclusions In patients with moderately dysfunctional BAVs, the presence of moderate aortic stenosis, aortopathy, and diastolic dysfunction determines symptom status, along with female gender and hypertension. Symptom status was associated with clinical outcomes.

AB - Background We aimed to identify the clinical and echocardiographic determinants of symptoms and their prognostic implications in patients with moderately dysfunctional bicuspid aortic valves (BAVs). Methods Among 1,019 subjects in the BAV registry treated in a single tertiary care center, the records of 127 patients (85 men, age 58±13 years) with moderately dysfunctional BAVs were comprehensively reviewed. The patients were divided into two groups based on symptom status: asymptomatic (n = 80) vs. symptomatic (n = 47). The primary end-point was defined as a composite of aortic valve surgery, hospitalization for heart failure, and any cause of death. Results The symptomatic group had a higher proportion of females, hypertension, aortic stenosis, and aortopathy than did the asymptomatic group. The symptomatic group showed lower e0 (5.5±1.7 vs. 6.5±2.2 cm/s, p = 0.003), higher E/e0 (13.3 ± 4.9 vs. 10.9±3.7, p = 0.002), and larger left atrial volume index (29.9±11.4 vs. 24.6±9.1 ml/m2 , p = 0.006) than did the asymptomatic group. In multivariate logistic regression analysis, female gender (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.10-7.36, p = 0.031), hypertension (OR 3.07, 95% CI 1.20-7.82, p = 0.019), moderate aortic stenosis (OR 5.33 5.78, 95% CI 1.99-16.83, p = 0.001), E/e0 >15 (OR 3.82, 95% CI 1.03-11.19, p = 0.015), and aortopathy (OR 2.76, 95% CI 1.07-7.10, p = 0.035) were independently correlated with symptom status. The symptomatic group showed a significantly lower rate of event-free survival during the 8-year follow-up period (54±9% vs. 68±10%, p = 0.001).Conclusions In patients with moderately dysfunctional BAVs, the presence of moderate aortic stenosis, aortopathy, and diastolic dysfunction determines symptom status, along with female gender and hypertension. Symptom status was associated with clinical outcomes.

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