Noninvasive estimate of left ventricular filling pressure correlated with early and midterm postoperative cardiovascular events after isolated aortic valve replacement in patients with severe aortic stenosis

Sung A. Chang, Pyo Won Park, Kiick Sung, Sang Chol Lee, Seung Woo Park, Young Tak Lee, Jae Kuen Oh

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objectives: The aim of this study was to investigate whether preoperative estimated left ventricular filling pressure predicts the postoperative outcome in patients with severe aortic stenosis. Methods: Two hundred ten patients who underwent isolated aortic valve replacement because of severe aortic stenosis were analyzed. Left ventricular filling pressure was noninvasively assessed based on the ratio between early diastolic mitral inflow and mitral annular velocity (E/E′), which was calculated based on results of mitral inflow and mitral annular tissue Doppler scanning. Early postoperative hospital events were reviewed. Postoperative mortality and morbidity were searched and compared according to left ventricular filling pressure. Results: Preoperative functional class was associated with increased E/E′ values. Postoperative hospital events were higher in patients with increased preoperative E/E′ values. Midterm mortality of the overall population was very low after aortic valve replacement (2%). Cardiovascular event-free survival, including hospital visits caused by heart failure symptoms, embolic cerebral infarction, and sudden cardiac death, was significantly lower in the patients with increased left ventricular filling pressure and E/E′ values of greater than 12 (P = .03). Multivariable analysis showed a high hazard ratio of increased E/E′ values of greater than 12 (hazard ratio, 41; P < .001). Conclusions: The incidence of postoperative mortality after isolated aortic valve replacement caused by severe aortic stenosis is relatively low in the current era. E/E′ representing diastolic filling pressure is the most important preoperative predictor of risk of early postoperative hospital course and postoperative morbidity.

Original languageEnglish (US)
Pages (from-to)1361-1366
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume140
Issue number6
DOIs
StatePublished - Dec 2010

Fingerprint

Aortic Valve Stenosis
Ventricular Pressure
Aortic Valve
Mortality
Morbidity
Sudden Cardiac Death
Cerebral Infarction
Disease-Free Survival
Heart Failure
Blood Pressure
Incidence
Population

Keywords

  • Aortic stenosis
  • Aortic valve replacement
  • AS
  • AVR
  • E/E′
  • LA
  • Left atrial
  • Left ventricular
  • Left ventricular ejection fraction
  • LV
  • LVEF
  • Ratio between early diastolic mitral inflow and mitral annular velocity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Noninvasive estimate of left ventricular filling pressure correlated with early and midterm postoperative cardiovascular events after isolated aortic valve replacement in patients with severe aortic stenosis. / Chang, Sung A.; Park, Pyo Won; Sung, Kiick; Lee, Sang Chol; Park, Seung Woo; Lee, Young Tak; Oh, Jae Kuen.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 140, No. 6, 12.2010, p. 1361-1366.

Research output: Contribution to journalArticle

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abstract = "Objectives: The aim of this study was to investigate whether preoperative estimated left ventricular filling pressure predicts the postoperative outcome in patients with severe aortic stenosis. Methods: Two hundred ten patients who underwent isolated aortic valve replacement because of severe aortic stenosis were analyzed. Left ventricular filling pressure was noninvasively assessed based on the ratio between early diastolic mitral inflow and mitral annular velocity (E/E′), which was calculated based on results of mitral inflow and mitral annular tissue Doppler scanning. Early postoperative hospital events were reviewed. Postoperative mortality and morbidity were searched and compared according to left ventricular filling pressure. Results: Preoperative functional class was associated with increased E/E′ values. Postoperative hospital events were higher in patients with increased preoperative E/E′ values. Midterm mortality of the overall population was very low after aortic valve replacement (2{\%}). Cardiovascular event-free survival, including hospital visits caused by heart failure symptoms, embolic cerebral infarction, and sudden cardiac death, was significantly lower in the patients with increased left ventricular filling pressure and E/E′ values of greater than 12 (P = .03). Multivariable analysis showed a high hazard ratio of increased E/E′ values of greater than 12 (hazard ratio, 41; P < .001). Conclusions: The incidence of postoperative mortality after isolated aortic valve replacement caused by severe aortic stenosis is relatively low in the current era. E/E′ representing diastolic filling pressure is the most important preoperative predictor of risk of early postoperative hospital course and postoperative morbidity.",
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T1 - Noninvasive estimate of left ventricular filling pressure correlated with early and midterm postoperative cardiovascular events after isolated aortic valve replacement in patients with severe aortic stenosis

AU - Chang, Sung A.

AU - Park, Pyo Won

AU - Sung, Kiick

AU - Lee, Sang Chol

AU - Park, Seung Woo

AU - Lee, Young Tak

AU - Oh, Jae Kuen

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N2 - Objectives: The aim of this study was to investigate whether preoperative estimated left ventricular filling pressure predicts the postoperative outcome in patients with severe aortic stenosis. Methods: Two hundred ten patients who underwent isolated aortic valve replacement because of severe aortic stenosis were analyzed. Left ventricular filling pressure was noninvasively assessed based on the ratio between early diastolic mitral inflow and mitral annular velocity (E/E′), which was calculated based on results of mitral inflow and mitral annular tissue Doppler scanning. Early postoperative hospital events were reviewed. Postoperative mortality and morbidity were searched and compared according to left ventricular filling pressure. Results: Preoperative functional class was associated with increased E/E′ values. Postoperative hospital events were higher in patients with increased preoperative E/E′ values. Midterm mortality of the overall population was very low after aortic valve replacement (2%). Cardiovascular event-free survival, including hospital visits caused by heart failure symptoms, embolic cerebral infarction, and sudden cardiac death, was significantly lower in the patients with increased left ventricular filling pressure and E/E′ values of greater than 12 (P = .03). Multivariable analysis showed a high hazard ratio of increased E/E′ values of greater than 12 (hazard ratio, 41; P < .001). Conclusions: The incidence of postoperative mortality after isolated aortic valve replacement caused by severe aortic stenosis is relatively low in the current era. E/E′ representing diastolic filling pressure is the most important preoperative predictor of risk of early postoperative hospital course and postoperative morbidity.

AB - Objectives: The aim of this study was to investigate whether preoperative estimated left ventricular filling pressure predicts the postoperative outcome in patients with severe aortic stenosis. Methods: Two hundred ten patients who underwent isolated aortic valve replacement because of severe aortic stenosis were analyzed. Left ventricular filling pressure was noninvasively assessed based on the ratio between early diastolic mitral inflow and mitral annular velocity (E/E′), which was calculated based on results of mitral inflow and mitral annular tissue Doppler scanning. Early postoperative hospital events were reviewed. Postoperative mortality and morbidity were searched and compared according to left ventricular filling pressure. Results: Preoperative functional class was associated with increased E/E′ values. Postoperative hospital events were higher in patients with increased preoperative E/E′ values. Midterm mortality of the overall population was very low after aortic valve replacement (2%). Cardiovascular event-free survival, including hospital visits caused by heart failure symptoms, embolic cerebral infarction, and sudden cardiac death, was significantly lower in the patients with increased left ventricular filling pressure and E/E′ values of greater than 12 (P = .03). Multivariable analysis showed a high hazard ratio of increased E/E′ values of greater than 12 (hazard ratio, 41; P < .001). Conclusions: The incidence of postoperative mortality after isolated aortic valve replacement caused by severe aortic stenosis is relatively low in the current era. E/E′ representing diastolic filling pressure is the most important preoperative predictor of risk of early postoperative hospital course and postoperative morbidity.

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KW - Left ventricular ejection fraction

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KW - LVEF

KW - Ratio between early diastolic mitral inflow and mitral annular velocity

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