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https://doi.org/10.15836/ccar2019.84

Outcomes in patients with aortic regurgitation treated according to recommendations – a single center study

Marija Mance ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Vlatka Rešković Lukšic ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Blanka Glavaš ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Martina Lovrić Benčić ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Joško Bulum ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Zvonimir Ostojić ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Jadranka Šeparović Hanževački ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

Sažetak

Introduction: Age and gender may influence the incidence of aortic regurgitation (AR) and its severity. Significant aortic regurgitation (sAR) is often treated surgically especially when symptomatic or when
systolic function declines.1-3 The aim of this study was to evaluate the outcomes in patients with sAR according to treatment strategy, age and gender differences in our study population.
Methods: In this retrospective descriptive single-center study an overall of 107 patients (22 female, 85 male) with significant AR in the last 5 years were analyzed. Patients were treated according to valid
recommendations, surgically (SUR) or conservatively (CON), except for 5 patients who refused surgery. Baseline and follow up (FU) data (AR severity, left ventricular ejection fraction (LVEF), ascending aorta
diameter (AA), treatment, comorbidities and major adverse cardiac events during FU), from documented medical history and digital imaging data were collected and analyzed. Additional sub-analysis was performed according to sex and age differences (above vs. below the age of 50). For statistical analysis a Chi-Square test was used.
Results: In the overall study population, during an average FU of 3.8 years, 16 patients (15%) developed major adverse cardiac events (MACE) with no statistically significant difference between gender
(p=0.846). Forty-six (43%) patients were surgically treated (87% male, 13% female) and 61 (54%) conservatively. LVEF did not worsen in FU period (54.1%, vs. 53.8%). In SUR, median age was 54 years, severe
AR was present in 93%, incidence of MACE was 21.7%, 80.4% patients were symptomatic and 14.5% had dilatation of AA more than 50 mm. In CON, MACE was present in 9.8% during FU (p=0.87), median age
was 64 years. Intermediate AR (48% vs 6.5%) and AA from 40-49 mm (80 vs 35%) was present more frequently as well as arterial hypertension (82 vs 70%) and chronic renal disease (23.2 vs 16.6%). The incidence of MACE was not found to be age-related (p=0.426).
Conclusion: In patients with sAR treated by either surgery or medication therapy only, during 3.8 years of FU, LVEF remained unchanged, while incidence of MACE was not found to be related to treatment strategy nor gender. In surgically treated patients, as expected, AR was more severe and AA was more dilated, while neither age nor gender had an impact on the incidence of MACE.

Ključne riječi

aortic regurgitation; treatment

Hrčak ID:

220620

URI

https://hrcak.srce.hr/220620

Datum izdavanja:

31.5.2019.

Posjeta: 1.079 *