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https://doi.org/10.15836/ccar2019.226

Long-term outcomes in patients with aortic regurgitation in the Zagreb University Hospital Centre

Marija Mance ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Vlatka Rešković Lukšić ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Ivan Bitunjac ; General Hospital “Dr. Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
Blanka Glavaš Konja ; 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
Dubravka Šipuš ; 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 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.
Patients and Methods: In this retrospective descriptive single-centre 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 ventricle ejection fraction (LVEF),
ascending aorta diameter (AA), treatment, comorbidities and major adverse cardiovascular events
(MACE) during FU), from documented medical history and digital imaging data were collected and
analysed. 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
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. Moderate 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 agerelated
(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; aortic valve replacement; outcomes

Hrčak ID:

226695

URI

https://hrcak.srce.hr/226695

Datum izdavanja:

15.10.2019.

Posjeta: 727 *