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Prognostic implications of the left atrial volume index in patients with progressive mitral stenosis
- Title
- Prognostic implications of the left atrial volume index in patients with progressive mitral stenosis
- Authors
- Cho I.-J.; Jeong H.; Choi J.-Y.; Lee S.-E.; Chang H.-J.
- Ewha Authors
- 조인정
- SCOPUS Author ID
- 조인정
- Issue Date
- 2019
- Journal Title
- Journal of Cardiovascular Imaging
- ISSN
- 2586-7210
- Citation
- Journal of Cardiovascular Imaging vol. 27, no. 2, pp. 122 - 133
- Keywords
- Left atrial volume; Mitral stenosis; Prognosis
- Publisher
- Korean Society of Echocardiography
- Indexed
- SCOPUS
- Document Type
- Article
- Abstract
- BACKGROUND: Limited data are available on the prognosis of progressive mitral stenosis (MS). We evaluated the factors associated with adverse events in patients with progressive MS. METHODS: We retrospectively analyzed 259 consecutive patients with pure progressive MS with a mitral valve area (MVA) between 1.5 and 2.0 cm2. The primary outcome measures were a composite endpoint of cardiac death, heart failure hospitalization, mitral valve surgery or percutaneous mitral valvuloplasty, and ischemic stroke. RESULTS: The mean patient age was 62 ± 12 years, and the mean MVA was 1.71 ± 0.15 cm2. Over a median follow-up duration of 52 months, a total of 41 patients (18.3%) experienced the composite endpoint. In multivariable Cox regression analysis, prior stroke (hazard ratio [HR], 4.54; 95% confidence interval [CI], 2.16–9.54; p < 0.001) and left atrial volume index (LAVI) of > 50 mL/m2 (HR, 4.45; 95% CI, 1.31–15.31; p = 0.017) were identified as independent predictors of the composite endpoint, even after adjusting for age and sex. Patients with a LAVI ≤ 50 mL/m2 demonstrated favorable event-free survival compared with those with a LAVI > 50 mL/m2 in either the overall population (p < 0.001) or asymptomatic patients (p = 0.002). Atrial fibrillation (AF), left ventricular mass index (LVMI), MVA, and mean diastolic pressure were factors independently associated with LAVI (all p < 0.05). CONCLUSIONS: A deleterious impact of a high LAVI on outcome was observed in patients with progressive MS. The LAVI was mainly influenced by the presence of AF, the severity of MS, and LVMI in this population. © 2019 Korean Society of Echocardiography.
- DOI
- 10.4250/jcvi.2019.27.e20
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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