Author + information
- Saki Ito,
- William Miranda,
- Vuyisile Nkomo,
- Sorin Pislaru,
- Joseph Malouf,
- Patricia Pellikka and
- Jae Oh
Objective: We hypothesized that comorbidities (hypertension, dyslipidemia, diabetes mellitus and obesity) result in worse survival in aortic stenosis (AS) patients by their contribution to left ventricular (LV) diastolic dysfunction (DD).
Method and Results: From 2011 to 2012, 538 consecutive patients with severe AS (aortic valve area [AVA] ≤1 cm2) were included. DD was defined as mitral inflow early diastolic velocity (E)/medial mitral annular early diastolic velocity (e'); E/e'>15 in sinus rhythm and E/e'>11 in atrial fibrillation using Doppler echocardiography. Mean age was 80.2±8.4 years (51% male) and AVA was 0.82±0.14 cm2. DD was present in 391 patients (73%). Larger body mass index (BMI), hypertension and diabetes mellitus predicted DD in multivariable model (p<0.05, Table, Model 1). BMI and hypertension were related to DD independent of LV mass index (p<0.05, Model 2). Median follow-up was 967 days and there were 332 deaths. Compared to patients without DD, DD was related to worse survival (2-year survival probability: DD 70% vs. no DD 85%, p < 0.01) even in the subset of 320 with aortic valve replacement (2-year survival probability: DD 77% vs. no DD 87%, p = 0.01). Diabetes mellitus predicted worse survival outcomes in patients with DD after adjusting for confounders.
Conclusions: In patients with severe AS, co-existing comorbid conditions influenced LV diastolic function independent of AS severity. Diabetes mellitus was additionally related to worse survival outcomes in AS patients with DD.
Moderated Poster Contributions
Valvular Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 11:30 a.m.-11:40 a.m.
Session Title: Novel Determinants of Outcomes in VHD
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1132M-15
- 2017 American College of Cardiology Foundation