論文

国際誌
2019年3月1日

Impact of concomitant tricuspid regurgitation on long-term outcomes in severe aortic stenosis.

European heart journal. Cardiovascular Imaging
  • Masashi Amano
  • ,
  • Chisato Izumi
  • ,
  • Tomohiko Taniguchi
  • ,
  • Takeshi Morimoto
  • ,
  • Makoto Miyake
  • ,
  • Shunsuke Nishimura
  • ,
  • Takeshi Kitai
  • ,
  • Takao Kato
  • ,
  • Kazushige Kadota
  • ,
  • Kenji Ando
  • ,
  • Yutaka Furukawa
  • ,
  • Tsukasa Inada
  • ,
  • Moriaki Inoko
  • ,
  • Katsuhisa Ishii
  • ,
  • Genichi Sakaguchi
  • ,
  • Fumio Yamazaki
  • ,
  • Tadaaki Koyama
  • ,
  • Tatsuhiko Komiya
  • ,
  • Kazuo Yamanaka
  • ,
  • Noboru Nishiwaki
  • ,
  • Naoki Kanemitsu
  • ,
  • Toshihiko Saga
  • ,
  • Tatsuya Ogawa
  • ,
  • Shogo Nakayama
  • ,
  • Hiroshi Tsuneyoshi
  • ,
  • Atsushi Iwakura
  • ,
  • Kotaro Shiraga
  • ,
  • Michiya Hanyu
  • ,
  • Nobuhisa Ohno
  • ,
  • Atsushi Fukumoto
  • ,
  • Tomoyuki Yamada
  • ,
  • Junichiro Nishizawa
  • ,
  • Jiro Esaki
  • ,
  • Kenji Minatoya
  • ,
  • Yoshihisa Nakagawa
  • ,
  • Takeshi Kimura

20
3
開始ページ
353
終了ページ
360
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1093/ehjci/jey105

AIMS: Tricuspid regurgitation (TR) has been reported to be associated with worse survival in various heart diseases, but there are few data in aortic stenosis (AS). METHODS AND RESULTS: In the Contemporary Outcomes after Surgery and Medical Treatment in Patients with Severe Aortic Stenosis (CURRENT AS) Registry enrolling 3815 consecutive patients with severe AS, there were 628 patients with moderate or severe TR (TR group) and 3187 patients with no or mild TR (no TR group). The study patients were subdivided into the initial aortic valve replacement (AVR) stratum (n = 1197) and the conservative stratum (n = 2618) according to treatment strategy. The primary outcome measure was a composite of aortic valve-related death or hospitalization due to heart failure. The 5-year freedom rate from the primary outcome measure was significantly lower in the TR group than in the no TR group (49.1% vs. 67.3%, P < 0.001). Even after adjusting for confounders, the excess risk of TR relative to no TR for the primary outcome measure remained significant [hazard ratio (HR): 1.25, 95% confidence interval (CI): 1.06-1.48; P = 0.008]. The trend for the excess adjusted risk in the TR group was consistent in the initial AVR and the conservative strata (HR 1.55, 95% CI: 0.97-2.48; P = 0.07; HR 1.22, 95% CI: 1.02-1.46; P = 0.03, respectively). In the initial AVR stratum, the 5-year freedom rate from the primary outcome measure was not different between the two groups with (n = 56) or without (n = 91) concomitant tricuspid annuloplasty (61.5% vs. 72.1%, P = 0.48). CONCLUSION: The presence of clinically significant TR concomitant with severe AS is associated with a poor long-term outcome, regardless of the initial treatment strategy.

リンク情報
DOI
https://doi.org/10.1093/ehjci/jey105
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30085068
ID情報
  • DOI : 10.1093/ehjci/jey105
  • PubMed ID : 30085068

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