The prognostic value of fQRSTa in patients with aortic stenosis undergoing surgical aortic valve replacement

Abstract

Background Surgical aortic valve replacement (sAVR) is the ultimate therapy for severe aortic stenosis (AS) in suitable patients. Prognostic factors of sAVR are great interest in recent studies. Frontal QRS‐T angle (fQRSTa) is a novel marker of ventricular repolarization abnormalities. In this study, we aimed to investigate the prognostic value of fQRSTa in patients with severe symptomatic AS undergoing sAVR. Methods A total of 372 patients with severe degenerative AS who underwent successful sAVR were included in this retrospective study. Then, patients were divided into two groups: patients with narrow fQRSTa (≤90°) as group 1 and wide fQRSTa (>90°) as group 2. Perioperative and postoperative clinical evaluation and time of death were recorded from all subjects. Results The incidence of total mortality was higher in patients with wider fQRSTa (13.8% [15]; 4.9% [9], P = .013) compared to patients with narrow fQRSTa. In multivariate logistic regression analysis, advanced age (odds ratio [OR] = 1.054; 95% confidence interval [CI] = 1.004‐1.106; P = .034), dyspnea (OR = 7.687; 95% CI = 2.296‐25.729; P = .001), lower efection fraction (OR = 0.924; 95% CI = 0.884‐0.966; P = .001), in‐hospital duration (OR = 1.051; 95% CI = 1.016‐1.088; P = .004) and wider fQRSTa (OR = 4.029; 95% CI = 1.383‐11.740; P = .011) were found to be independent predictors of mortality. Additionally, a Kaplan‐Meier survival analysis also revealed that long‐term survival was found to be significantly decreased in patients with wider fQRSTa (log‐rank P = .014). Conclusion fQRSTa was related with poor prognosis in patients with AS undergoing sAVR. fQRSTa was also an independent predictor of mortality in this population.

Novel markers of ventricular repolarization are associated with mortality in patients undergoing surgical aortic valve replacement for severe aortic stenosis

“…Receiver-operating characteristic curves indicating the discriminative ability of the QT interval, Tp-e interval, Tp-e dispersion, Tp-e/QT ratio, and Tp-e/QTc ratio for mortality evaluated in terms of mortality. It was associated with worse prognosis in patients with AS undergoing surgical AVR 3. This supported our finding which showed that myocardial heterogeneity before operation was related with increased risk of mortality.…”

“…1 In previous studies, several prognostic markers were described to predict high risk severe AS patient. 2,3 Ventricular repolarization abnormalities were studied in several cardiac diseases. Thus, it is well known that repolarization abnormalities were related with adverse cardiovascular events.…”

“…Thus, it is well known that repolarization abnormalities were related with adverse cardiovascular events. 3,4 Surface electrocardiography was used to determine ventricular depolarization and repolarization process. Tp-e interval is the time that is between the peak and the end of T wave.…”

Prognostic influence of objective nutritional indexes on mortality after surgical aortic valve replacement in elderly patients with severe aortic stenosis (from the nutrition‐SAVR trial)

“…Severe aortic stenosis (AS) is a common heart valve disease, especially in the elderly population 1,2 . Considering the increase in the rate of elderly patients in the world population, especially in Europe, the prevalence of degenerative severe AS probably will increase in the near future 3,4 .…”

“…Severe aortic stenosis (AS) is a common heart valve disease, especially in the elderly population. 1,2 Considering the increase in the rate of elderly patients in the world population, especially in Europe, the prevalence of degenerative severe AS probably will increase in the near future. 3,4 The most common treatment method used in these patients is surgical aortic valve replacement (SAVR), but the rate of transcatheter aortic valve replacement (TAVR) is increasing rapidly especially in the elder population.…”