کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5975469 1576214 2013 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Progression of aortic stenosis in elderly patients over long-term follow up
ترجمه فارسی عنوان
پیشرفت تنگی آئورت در بیماران سالمند در پیگیری طولانی مدت
کلمات کلیدی
تنگی آئورت، پیشرفت، مسن، همبودی، وجود همزمان دو بیماری، نارسایی کلیه،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی

BackgroundThe natural history of aortic stenosis (AS) in elderly patients remains poorly defined. In an elderly cohort over long-term follow-up, we assessed: 1) rates and predictors of hemodynamic progression and 2) composite aortic valve replacement (AVR) or death endpoint.MethodsConsecutive Department of Veterans' Affairs patients with AS (> 60 years) were prospectively enrolled between 1988 and 1994 (n = 239) and followed until 2008. Patients with ≥ 2 trans-thoracic echocardiograms > 6 months apart were included in the progression analysis (n = 147). Baseline demographics, comorbidities and echocardiography parameters were recorded. Follow-up was censored at AVR/death.ResultsThe age of patients was 73 ± 6 years; 82% were male. Baseline AS severity was mild (67%), moderate (23%) and severe (10%). Follow-up was 6.5 ± 4 years (range: 1-17 years). Annualized mean aortic valve gradient progression rates were: mild AS 4 ± 4 mm Hg/year; moderate AS 6 ± 5 mm Hg/year and severe AS 10 ± 8 mm Hg/year (p < 0.001). Five-year event-free survival was 66 ± 5%, 23 ± 7% and 20 ± 10% for mild, moderate and severe AS respectively. Progression to severe AS occurred in 35% and 74% of patients with mild and moderate AS respectively. Independent predictors of rapid progression were: baseline AS severity (per grade) (OR 2.6, p = 0.001), aortic valve calcification (per grade) (OR 2.1, p = 0.01), severe renal impairment (OR 4.0, p = 0.04) and anemia (OR 2.3, p = 0.05).ConclusionsIn elderly patients, hemodynamic progression of AS is predicted by AS severity, renal function, aortic valve calcification and history of anemia. These factors identify patients at high risk of rapid hemodynamic progression, for whom more frequent clinical and echocardiographic surveillance is advisable.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Cardiology - Volume 167, Issue 4, 20 August 2013, Pages 1226-1231
نویسندگان
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