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논문 기본 정보

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학술저널
저자정보
Jin Kyung Oh (Chungnam National University Hospital) Jae-Hyeong Park (Chungnam National University Hospital Chungnam National University School of Medicine Daejeon) Jin Kyung Hwang (Veterans Health Service Medical Center) Chang Hoon Lee (Veterans Health Service Medical Center) JongSeon Park (Veterans Health Service Medical Center) Joong-Il Park (Veterans Health Service Medical Center) Hoon-Ki Park (Veterans Health Service Medical Center) Jung Sun Cho (Daejeon St. Mary's Hospital The Catholic University of Korea College of Medicine) Bong-suk Seo (Chungnam National University Hospital) Seok-Woo Seong (Chungnam National University Hospital) Byung Joo Sun (Chungnam National University Hospital) Jae-Hwan Lee (Chungnam National University Hospital) In Whan Seong (Chungnam National University Hospital)
저널정보
대한심장학회 Korean Circulation Journal Korean Circulation Journal Vol.49 No.2
발행연도
2019.1
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160 - 169 (10page)

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Background and Objectives: Aortic valve replacement (AVR) is the treatment of choice in severe symptomatic aortic stenosis (AS) patients. However, a substantial number of elderly patients refuse AVR and treated medically. We investigated their long-term prognosis. Methods: From January 2005 to December 2016, we analyzed elderly patients with severe symptomatic AS who refused to have AVR. Results: After screening of total 534 patients, we analyzed total 180 severe symptomatic AS patients (78±7 years old, 96 males). Hypertension was the most common cardiovascular risk factor (72%) and the most common symptom was dyspnea (66%). Calculated aortic stenosis area was 0.73±0.20 cm2 and mean left ventricular ejection fraction (LVEF) was 57.8±12.2%. Total 102 patients died during follow-up period (39.1±31.0 months). One-, 3-, and 5-year all-cause mortality rate was 21.1±3.0%, 43.1±3.8%, and 56.5±4.2%, respectively. Of them, 87 died from cardiac causes, and 1-, 3-, and 5-year cardiac mortality rate was 18.0±2.9%, 38.2±3.8%, and 50.7±4.3%, respectively. Their all-cause mortality and cardiac mortality were significantly higher than those of controls. Univariate analysis showed that age, anemia, LVEF, and Log N-terminal pro B-type natriuretic peptide (NT-proBNP) were significant parameters in all-cause mortality (p<0.001, p=0.001, p=0.039, and p=0.047, respectively) and in cardiac mortality (p<0.001, p<0.001, p=0.046, and p=0.026, respectively). Multivariate analysis showed that age and anemia were significant prognostic factors for cardiac and all-cause mortality. Conclusions: In elderly severe symptomatic AS patients who treated medically, their 1-, 3- and 5-year all-cause mortality rate was 21.1±3.0%, 43.1±3.8%, and 56.5±4.2%, respectively. Age and anemia were significant prognostic factors for cardiac and all-cause mortality.
#Aortic valve stenosis #Survival #Prognosis #Drug therapy

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참고문헌 (15)

참고문헌 신청
Nkomo VT / 2006 / Burden of valvular heart diseases : a population-based study / Lancet 368:1005~1011 google schola Bach DS / 2007 / Prevalence, referral patterns, testing, and surgery in aortic valve disease : leaving women and elderly patients behind / J Heart Valve Dis 16:362~369 google schola Ross J Jr / 1968 / Aortic stenosis / Circulation 38(1 Suppl):61~67 google schola Frank S / 1973 / Natural history of valvular aortic stenosis / Br Heart J 35:41~46 google schola Jang SY / 2014 / Changes in the etiology of valvular heart disease in the rapidly aging Korean population / Int J Cardiol 174:355~359 google schola

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