| Pulmonary hypertension and long-term mortality in aortic and mitral regurgitation. | |
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MedLine Citation:
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PMID: 21035592 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Outcomes data in patients with aortic regurgitation or mitral regurgitation have been limited to small series with generally <10 years of follow-up. The quantitative impact of pulmonary artery hypertension has not been well described. The purpose of this study was to describe the 15-year mortality of aortic regurgitation and mitral regurgitation. METHODS: Our institution's electronic echocardiography database was queried to identify those patients examined in 1992 and reported to have at least mild aortic regurgitation or mitral regurgitation. Patients were classified by semi-quantitative degree of regurgitation. Pulmonary artery systolic pressure was categorized as normal, borderline, mild, or moderate or greater hypertension (pulmonary artery systolic pressure >40 mm Hg). Age-stratified Cox proportional hazards models compared survival among groups and adjusted for sex, depressed left ventricular ejection fraction, and pulmonary artery systolic pressure. Mortality data were obtained from the 2008 Social Security Death Index. RESULTS: Of 4984 echocardiograms performed in 4050 patients, 1156 patients (28%; aged 72±14 years) had at least mild aortic regurgitation and 1971 patients (49%; aged 69±16 years) had at least mild mitral regurgitation. Overall 15-year mortality in patients with aortic regurgitation was 74% and similar for all grades of aortic regurgitation. Overall 15-year mortality in patients with mitral regurgitation was 71% and got progressively worse with increasing severity grade of mitral regurgitation (63% for mild to 81% for at least moderate-to-severe). For both aortic and mitral regurgitation, moderate or greater pulmonary artery systolic hypertension was associated with increased mortality (in patients with aortic regurgitation, hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.58-2.41, and in mitral regurgitation patients, HR, 1.48; 95% CI, 1.26-1.75). CONCLUSION: Long-term (15-year) survival of patients with aortic regurgitation is poor and is independent of regurgitation severity. In contrast, long-term survival of patients with mitral regurgitation correlates with regurgitation severity. For both groups, moderate or greater pulmonary artery systolic hypertension identified those at highest risk. |
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Authors:
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Matthew W Parker; Murray A Mittleman; Carol A Waksmonski; Greg Sanders; Marilyn F Riley; Pamela S Douglas; Warren J Manning |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of medicine Volume: 123 ISSN: 1555-7162 ISO Abbreviation: Am. J. Med. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-01 Completed Date: 2010-11-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: United States |
Other Details:
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Languages: eng Pagination: 1043-8 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Aged Aortic Valve Insufficiency / complications, mortality* Confidence Intervals Echocardiography Female Humans Hypertension, Pulmonary / complications, mortality* Kaplan-Meier Estimate Male Mitral Valve Insufficiency / complications, mortality* Proportional Hazards Models Sex Factors Stroke Volume |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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