Prognóstico da esclerose valvar aórtica na mortalidade cardíaca de pacientes atendidos no instituto de cardiologia do Rio Grande do Sul

Rosa, Eduardo Maffini da; Sant'Anna, João Ricardo Michielin; Oppermann, Luciana Pimentel; Castro, Iran

doi:10.1590/s0066-782x2007000200016

Cited by 10 publications

(5 citation statements)

References 43 publications

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“…In the pathological results found on Doppler echocardiography, a compromised left ventricular systolic function had a prevalence of 9.5%, inferior to that reported by Rosa et al 10 who registered a prevalence of 17.2% with a strong statistical significance in both studies (p < 0.001).…”

Section: Discussioncontrasting

confidence: 82%

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Association of Aortic Valve Sclerosis with Previous Coronary Artery Disease and Risk Factors

Marmelo¹,

Mateus²,

Pereira³

2014

Arquivos Brasileiros De Cardiologia

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BackgroundAortic valve sclerosis (AVS) is characterized by increased thickness, calcification and stiffness of the aortic leaflets without fusion of the commissures. Several studies show an association between AVS and presence of coronary artery disease.ObjectiveThe aim of this study is to investigate the association between presence of AVS with occurrence of previous coronary artery disease and classical risk factors.MethodsThe sample was composed of 2,493 individuals who underwent transthoracic echocardiography between August 2011 and December 2012. The mean age of the cohort was 67.5 ± 15.9 years, and 50.7% were female.ResultsThe most frequent clinical indication for Doppler echocardiography was the presence of stroke (28.8%), and the most common risk factor was hypertension (60.8%). The most prevalent pathological findings on Doppler echocardiography were mitral valve sclerosis (37.1%) and AVS (36.7%). There was a statistically significant association between AVS with hypertension (p < 0.001), myocardial infarction (p = 0.007), diabetes (p = 0.006) and compromised left ventricular systolic function (p < 0.001). Conclusion: Patients with AVS have higher prevalences of hypertension, stroke, hypercholesterolemia, myocardial infarction, diabetes and compromised left ventricular systolic function when compared with patients without AVS. We conclude that there is an association between presence of AVS with previous coronary artery disease and classical risk factors.

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Section: Discussioncontrasting

confidence: 82%

“…In the studied cohort, we could observe a balance between the prevalence of AVS in males and females (17.3% / 19.4%), which is consistent with findings from other studies. Also, the advanced mean age observed (67.5 years) confirms that AVS, as a degenerative pathology, affects mainly older age groups 10 .…”

Section: Discussionsupporting

confidence: 60%

Association of Aortic Valve Sclerosis with Previous Coronary Artery Disease and Risk Factors

Marmelo¹,

Mateus²,

Pereira³

2014

Arquivos Brasileiros De Cardiologia

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“…In 2006, a second study on more than 3,500 community-dwelling adults with a mean age of 76 years, found similar results with a 23% increase in the risk of all-cause mortality in AVSc patients ( 20 ). In contrast, a successive study, evaluating more than 8,500 community-dwelling adults with a mean age of 56 years, showed that there was no association between AVSc presence and all-cause mortality ( 21 ). However, the last study, even if performed on a larger cohort, had an overall mortality of 3.5%, while in the two previous ones it was around 15%.…”

Section: Discussionmentioning

confidence: 99%

Aortic Valve Sclerosis in High-Risk Coronary Artery Disease Patients

Myasoedova

Genovese

Cavallotti

et al. 2021

Front. Cardiovasc. Med.

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Background: Current knowledge regarding the relationship between aortic valve sclerosis (AVSc), cardiovascular risk factors, and mortality in patients with known coronary artery disease (CAD) is still unclear. The present study aimed at investigating the prevalence of AVSc as well as its association with long-term all-cause mortality in high-risk CAD patients that has never been explored in large cohorts thus far.Methods and Results: In this retrospective and observational cohort study we enrolled high-risk CAD patients, hospitalized at Centro Cardiologico Monzino (CCM), Milan, Italy, between January 2006 and December 2016. The morphology and function of the aortic valve were assessed from the recorded echocardiographic images to evaluate the presence of AVSc, defined as a non-uniform thickening of the aortic leaflets with no consequences on hemodynamics. Data on 5-year all-cause mortality was retrieved from a Regional database. Of the 5,489 patients initially screened, 4,938 (mean age 67 ± 11 years, 3,954 [80%] men) were enrolled in the study. In the overall population, AVSc was detected in 2,138 (43%) patients. Multivariable LASSO regression revealed that age, female gender, diabetes mellitus, previous MI, and left ventricular ejection fraction were independently associated with AVSc. All-cause mortality (adjusted hazard ratio: 1.29, 95%CI: 1.05–1.58) was significantly higher in AVSc than in non-AVSc patients.Conclusions: AVSc is frequently detected in high-risk CAD patients and is associated with long-term mortality. Our findings corroborate the hypothesis that AVSc is an underestimated marker of systemic cardiovascular risk. Thus, AVSc detection may be used to improve long-term risk stratification of high-risk CAD patients.

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“…In the general population, AVSc is a rather common feature, with a prevalence ranging from 30 to 40% [1,3,13] and AVSc has been associated with an increased risk of all-cause and CV mortality in many [5,6,14,15,16,17,18,19] but not all [20] studies. Several authors have shown that the risk of dying from any-cause or for CV reasons in subjects with AVSc is significantly greater than in those without, even after adjustment for several risk factors [6,14,21].…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have shown that the risk of dying from any-cause or for CV reasons in subjects with AVSc is significantly greater than in those without, even after adjustment for several risk factors [6,14,21]. Other authors, however, have shown that such increased-risk is totally eliminated when analyses were adjusted for CV risk factors [20]. AVSc, alone or included into cardiac calcium scores, also confers a greater risk of all-cause and CV mortality in subjects with no history of CV disease [14], in subjects with type 2 diabetes mellitus with or without history of myocardial infarction [16], and in patients hospitalized for overt or suspected CAD [22].…”

Section: Discussionmentioning

confidence: 99%

Aortic Valve Sclerosis Adds to Prediction of Short-Term Mortality in Patients with Documented Coronary Atherosclerosis

Poggio

Cavallotti

Myasoedova

et al. 2019

JCM

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Aims: Aortic valve sclerosis (AVSc), a non-uniform thickening of leaflets with an unrestricted opening, is characterized by inflammation, lipoprotein deposition, and matrix degradation. In the general population, AVSc predicts long-term cardiovascular mortality (+50%) even after adjustment for vascular risk factors and clinical atherosclerosis. We have hypothesized that AVSc is a risk-multiplier able to predict even short-term mortality. To address this issue, we retrospectively analyzed 90-day mortality of all patients who underwent isolated coronary artery bypass grafting (CABG) at Centro Cardiologico Monzino over a ten-year period (2006–2016). Methods: We analyzed 2246 patients and 90-day all-cause mortality was 1.5% (31 deaths). We selected only patients deceased from cardiac causes (n = 29) and compared to alive patients (n = 2215). A cardiologist classified the aortic valve as no-AVSc (n = 1352) or AVSc (n = 892). Cox linear regression and integrated discrimination improvement (IDI) analyses were used to evaluate AVSc in predicting 90-day mortality. Results: AVSc 90-day survival (97.6%) was lower than in no-AVSc (99.4%; p < 0.0001) with a hazard ratio (HR) of 4.0 (95%CI: 1.78, 9.05; p < 0.0001). The HR for AVSc, adjusted for propensity score, was 2.7 (95%CI: 1.17, 6.23; p = 0.02) and IDI statistics confirmed that AVSc significantly adds (p < 0.001) to the identification of high-risk patients than EuroSCORE II alone. Conclusion: Our data supports the hypothesis that a risk stratification strategy based on AVSc, added to ESII, may allow better recognition of patients at high-risk of short-term mortality after isolated surgical myocardial revascularization. Results from this study warrant further confirmation.

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Prognóstico da esclerose valvar aórtica na mortalidade cardíaca de pacientes atendidos no instituto de cardiologia do Rio Grande do Sul

Abstract: The presence of aortic valve sclerosis was not associated with increased risk for all-cause and cardiovascular mortality in the population studied.

Cited by 10 publications

References 43 publications

Association of Aortic Valve Sclerosis with Previous Coronary Artery Disease and Risk Factors

Association of Aortic Valve Sclerosis with Previous Coronary Artery Disease and Risk Factors

Aortic Valve Sclerosis in High-Risk Coronary Artery Disease Patients

Aortic Valve Sclerosis Adds to Prediction of Short-Term Mortality in Patients with Documented Coronary Atherosclerosis

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