Survival Benefit of Aortic Valve Replacement in Patients With Severe Aortic Regurgitation and Pulmonary Hypertension

Khandhar, Sumit; Varadarajan, Padmini; Turk, Rami; Sampat, Unnati; Patel, Reena; Kamath, Ashvin; Pai, Ramdas G.

doi:10.1016/j.athoracsur.2009.05.025

Cited by 39 publications

(22 citation statements)

References 8 publications

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“…A prevalência de HP na IAo importante varia de 11% a 16% 320 e está associada a presença de IM, disfunção de VE, maiores diâmetros ventriculares e FA 321 . Um estudo observacional com acompanhamento médio de 15 anos mostrou que nos pacientes com IAo a presença de HP esteve associada ao dobro de mortalidade, quando comparados àqueles com PSAP normal, manejados clinicamente 322 .A mortalidade cirúrgica dos pacientes com IAo e HP é de aproximadamente 10% em um ano, enquanto nos pacientes com IAo que permanecem em tratamento clínico a mortalidade é de 42% no mesmo período.…”

Section: Hipertensão Pulmonar Nas Valvopatiasunclassified

Diretriz Brasileira de Valvopatias - SBC 2011/ I Diretriz Interamericana de Valvopatias - SIAC 2011

Tarasoutchi¹,

Montera²,

Grinberg³

et al. 2011

Arq. Bras. Cardiol.

126

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Os anúncios veiculados nesta edição são de exclusiva responsabilidade dos anunciantes, assim como os conceitos emitidos em artigos assinados são de exclusiva responsabilidade de seus autores, não refletindo necessariamente a opinião da SBC. Todos os direitos reservados e protegidos pela lei 9.610 de 19/02/98. Nenhuma parte desta publicação poderá ser reproduzida sem autorização prévia por escrito dos Editores, sejam quais forem os meio empregados: eletrônico, mecânico, fotográfico, gravação ou quaisquer outros. Material de distribuição exclusiva à classe médica. Os Arquivos Brasileiros de Cardiologia não se responsabilizam pelo acesso indevido a seu conteúdo e que contrarie a determinação em atendimento à Resolução da Diretoria Colegiada (RDC) nº 96/08 da Agência Nacional de Vigilância Sanitária (Anvisa), que atualiza o regulamento técnico sobre Propaganda, Publicidade, Promoção e informação de Medicamentos. Segundo o artigo 27 da insígnia, "a propaganda ou publicidade de medicamentos de venda sob prescrição deve ser restrita, única e exclusivamente, aos profissionais de saúde habilitados a prescrever ou dispensar tais produtos (...)". Garantindo o acesso universal, o conteúdo científico do periódico continua disponível para acesso gratuito e integral a todos os interessados no endereço: www.arquivosonline.com.br.

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Section: Hipertensão Pulmonar Nas Valvopatiasunclassified

Diretriz Brasileira de Valvopatias - SBC 2011/ I Diretriz Interamericana de Valvopatias - SIAC 2011

Tarasoutchi¹,

Montera²,

Grinberg³

et al. 2011

Arq. Bras. Cardiol.

126

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“…Prior studies have reported a prevalence of PH in 10–20% of patients with severe AR [41]. The pathophysiology is explained by a chronic elevation of the LVEDP, which in turn, leads to an increase in LA and PA pressures or due to the acute elevation in LVEDP with acute severe AR (such as what might be observed in endocarditis or aortic dissection).…”

Section: Aortic Regurgitationmentioning

confidence: 99%

“…Furthermore, PA pressures declined to near-normal values in the vast majority of patients following AVR [42]. More recently, a single-center retrospective study of 506 patients with severe AR demonstrated that severe PH was statistically associated with lower LVEF, greater LV end-diastolic and end-systolic dimensions, and a higher grade of concomitant MR [41]. Moreover, multivariate analysis with propensity score adjustment showed an independent association between AVR and survival in patients with both severe PH and severe AR during 5 years of followup [41].…”

Section: Aortic Regurgitationmentioning

confidence: 99%

Pulmonary Hypertension Related to Left-Sided Cardiac Pathology

Kiefer

Bashore

2011

Pulmonary Medicine

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Pulmonary hypertension (PH) is the end result of a variety of diverse pathologic processes. The chronic elevation in pulmonary artery pressure often leads to right ventricular pressure overload and subsequent right ventricular failure. In patients with left-sided cardiac disease, PH is quite common and associated with increased morbidity and mortality. This article will review the literature as it pertains to the epidemiology, pathogenesis, and diagnosis of PH related to aortic valve disease, mitral valve disease, left ventricular systolic and diastolic dysfunction, and pulmonary veno-occlusive disease. Moreover, therapeutic strategies, which focus on treating the underlying cardiac pathology will be discussed.

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“…Severe PH (sPAP >60 mm Hg) was reported in 16% to 24% of patients with severe chronic AR. 38,39 The prognostic value of resting PH is not completely elucidated. In a recent retrospective study including 506 patients with severe AR, Khandhar and colleagues 38 showed that severe PH was associated with LV dysfunction and functional MR and returned to normal in most cases after surgery.…”

Section: Resting Pulmonary Hypertension and Aortic Regurgitationmentioning

confidence: 99%

“…38,39 The prognostic value of resting PH is not completely elucidated. In a recent retrospective study including 506 patients with severe AR, Khandhar and colleagues 38 showed that severe PH was associated with LV dysfunction and functional MR and returned to normal in most cases after surgery. AVR was an independent predictor of better survival at 5 years follow-up in patients with both severe chronic AR and severe PH.…”

Section: Resting Pulmonary Hypertension and Aortic Regurgitationmentioning

confidence: 99%

The Right Heart-Pulmonary Circulation Unit and Left Heart Valve Disease

Filippetti¹,

Voilliot

Bellino

et al. 2018

Heart Failure Clinics

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Valvular heart disease (VHD) is frequently accompanied by pulmonary hypertension (PH). In asymptomatic patients, PH is rare, although the exact prevalence is unknown and mainly stems from the severity of the VHD and the presence of diastolic dysfunction. PH can also be depicted during exercise echocardiography. PH either at rest or during exercise is also a powerful determinant of outcome and is independently associated with reduced survival, regardless of the severity of the underlying valvular pathology. Therefore, because PH is a marker of poor prognosis, assessment of PH in VHD is crucial for risk stratification and management of patients with VHD.

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Survival Benefit of Aortic Valve Replacement in Patients With Severe Aortic Regurgitation and Pulmonary Hypertension

Cited by 39 publications

References 8 publications

Diretriz Brasileira de Valvopatias - SBC 2011/ I Diretriz Interamericana de Valvopatias - SIAC 2011

Diretriz Brasileira de Valvopatias - SBC 2011/ I Diretriz Interamericana de Valvopatias - SIAC 2011

Pulmonary Hypertension Related to Left-Sided Cardiac Pathology

The Right Heart-Pulmonary Circulation Unit and Left Heart Valve Disease

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