Background
Some sufferers have extreme aortic valve stenosis (AS) regardless of a decrease diploma of aortic valve calcification (AVC). This examine in contrast the medical options and prognosis of sufferers present process aortic valve substitute (AVR) for extreme AS with a low AVC rating in contrast with these with larger AVC scores.
Strategies
This examine included 1002 Korean sufferers with symptomatic extreme degenerative AS who underwent AVR. We measured AVC rating earlier than AVR and outlined low AVC as AVC rating of <2000 models for male sufferers and <1300 models for feminine sufferers. Sufferers with bicuspid or rheumatic aortic valve illness had been excluded.
Outcomes
The imply age was 75.6±7.9 years and 487 sufferers (48.6%) had been feminine. Imply left ventricular ejection fraction was 59.4%±10.4%, and concomitant coronary revascularisation was carried out in 96 sufferers (9.6%). The median aortic valve calcium rating was 3122 models (IQR 2249–4289 models) amongst male sufferers and 1756 models (IQR 1192–2572) amongst feminine sufferers. A complete of 242 sufferers (24.2%) had low AVC; they had been considerably youthful (73.5±8.7 years vs 76.3±7.5 years, p<0.001) and had been extra prone to be feminine (59.5% vs 45.1%, p<0.001) and on haemodialysis (5.4% vs 1.8%, p=0.006) than these with excessive AVC. Throughout a follow-up (median: 3.8 years), the sufferers with low AVC had considerably larger threat of dying from any trigger (adjusted HR 1.60, 95% CI 1.02 to 2.52, p=0.04), largely non-cardiac trigger.
Conclusions
Sufferers with low AVC exhibit distinct medical traits and the next threat of long-term mortality in contrast with these with excessive AVC.