Moderate patient-prosthesis mismatch predicts cardiac events and advanced functional class in young and middle-aged patients undergoing surgery due to severe aortic stenosis

Daniel Hernandez-Vaquero, Jose M. Garcia, Rocio Diaz, David Calvo, Zain I Khalpey, Ernesto Hernández, Víctor Rodriguez, César Morís, Juan C. Llosa

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background and Aim The clinical impact of patient-prosthesis mismatch (PPM) on outcomes in young and middle-aged patients undergoing surgery for aortic valve replacement (AVR) remains unknown. Our objective was to examine the mid-term impact of PPM on overall mortality, quality of life, and cardiac events in this population. Methods All patients younger than 70 years of age undergoing isolated AVR from October 2005 to October 2011 were analyzed. PPM was defined as the indexed effective orifice area ≤0.85 cm2/m 2. We studied the impact of PPM on mid-term overall mortality, cardiac events, and New York Heart Association functional class using an analysis stratified for propensity score. Cardiac events were defined as cardiac death, sudden death, hospital readmission due to angina, syncope or heart failure or reoperation on aortic prosthesis. Results Two hundred and ninety-three patients were included in the study, of whom 81 (27.61%) had some degree of PPM. PPM had no impact on mid-term overall mortality (HR = 1.45; 95% CI = 0.65-3.22; p = 0.36), although it had a negative impact on cardiac events (HR = 11.52; 95% CI = 5.25-25.24; p < 0.001) and functional class (RR = 7.55; 95% CI = 2.59-22.03; p < 0.001). Conclusions Moderate PPM appears to be a strong and independent predictor of cardiac events and advanced functional class in young and middle-aged patients undergoing AVR for severe stenosis. However, it is possible that it has no impact on overall mortality. doi: 10.1111/jocs.12265 (J Card Surg 2014;29:127-133)

Original languageEnglish (US)
Pages (from-to)127-133
Number of pages7
JournalJournal of Cardiac Surgery
Volume29
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Aortic Valve Stenosis
Prostheses and Implants
Aortic Valve
Mortality
Patient Readmission
Propensity Score
Syncope
Sudden Death
Reoperation
Pathologic Constriction
Heart Failure
Quality of Life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Moderate patient-prosthesis mismatch predicts cardiac events and advanced functional class in young and middle-aged patients undergoing surgery due to severe aortic stenosis. / Hernandez-Vaquero, Daniel; Garcia, Jose M.; Diaz, Rocio; Calvo, David; Khalpey, Zain I; Hernández, Ernesto; Rodriguez, Víctor; Morís, César; Llosa, Juan C.

In: Journal of Cardiac Surgery, Vol. 29, No. 2, 2014, p. 127-133.

Research output: Contribution to journalArticle

Hernandez-Vaquero, Daniel ; Garcia, Jose M. ; Diaz, Rocio ; Calvo, David ; Khalpey, Zain I ; Hernández, Ernesto ; Rodriguez, Víctor ; Morís, César ; Llosa, Juan C. / Moderate patient-prosthesis mismatch predicts cardiac events and advanced functional class in young and middle-aged patients undergoing surgery due to severe aortic stenosis. In: Journal of Cardiac Surgery. 2014 ; Vol. 29, No. 2. pp. 127-133.
@article{5cddd8b8c0fc438ba5cdf1ef6b31512e,
title = "Moderate patient-prosthesis mismatch predicts cardiac events and advanced functional class in young and middle-aged patients undergoing surgery due to severe aortic stenosis",
abstract = "Background and Aim The clinical impact of patient-prosthesis mismatch (PPM) on outcomes in young and middle-aged patients undergoing surgery for aortic valve replacement (AVR) remains unknown. Our objective was to examine the mid-term impact of PPM on overall mortality, quality of life, and cardiac events in this population. Methods All patients younger than 70 years of age undergoing isolated AVR from October 2005 to October 2011 were analyzed. PPM was defined as the indexed effective orifice area ≤0.85 cm2/m 2. We studied the impact of PPM on mid-term overall mortality, cardiac events, and New York Heart Association functional class using an analysis stratified for propensity score. Cardiac events were defined as cardiac death, sudden death, hospital readmission due to angina, syncope or heart failure or reoperation on aortic prosthesis. Results Two hundred and ninety-three patients were included in the study, of whom 81 (27.61{\%}) had some degree of PPM. PPM had no impact on mid-term overall mortality (HR = 1.45; 95{\%} CI = 0.65-3.22; p = 0.36), although it had a negative impact on cardiac events (HR = 11.52; 95{\%} CI = 5.25-25.24; p < 0.001) and functional class (RR = 7.55; 95{\%} CI = 2.59-22.03; p < 0.001). Conclusions Moderate PPM appears to be a strong and independent predictor of cardiac events and advanced functional class in young and middle-aged patients undergoing AVR for severe stenosis. However, it is possible that it has no impact on overall mortality. doi: 10.1111/jocs.12265 (J Card Surg 2014;29:127-133)",
author = "Daniel Hernandez-Vaquero and Garcia, {Jose M.} and Rocio Diaz and David Calvo and Khalpey, {Zain I} and Ernesto Hern{\'a}ndez and V{\'i}ctor Rodriguez and C{\'e}sar Mor{\'i}s and Llosa, {Juan C.}",
year = "2014",
doi = "10.1111/jocs.12265",
language = "English (US)",
volume = "29",
pages = "127--133",
journal = "Journal of Cardiac Surgery",
issn = "0886-0440",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Moderate patient-prosthesis mismatch predicts cardiac events and advanced functional class in young and middle-aged patients undergoing surgery due to severe aortic stenosis

AU - Hernandez-Vaquero, Daniel

AU - Garcia, Jose M.

AU - Diaz, Rocio

AU - Calvo, David

AU - Khalpey, Zain I

AU - Hernández, Ernesto

AU - Rodriguez, Víctor

AU - Morís, César

AU - Llosa, Juan C.

PY - 2014

Y1 - 2014

N2 - Background and Aim The clinical impact of patient-prosthesis mismatch (PPM) on outcomes in young and middle-aged patients undergoing surgery for aortic valve replacement (AVR) remains unknown. Our objective was to examine the mid-term impact of PPM on overall mortality, quality of life, and cardiac events in this population. Methods All patients younger than 70 years of age undergoing isolated AVR from October 2005 to October 2011 were analyzed. PPM was defined as the indexed effective orifice area ≤0.85 cm2/m 2. We studied the impact of PPM on mid-term overall mortality, cardiac events, and New York Heart Association functional class using an analysis stratified for propensity score. Cardiac events were defined as cardiac death, sudden death, hospital readmission due to angina, syncope or heart failure or reoperation on aortic prosthesis. Results Two hundred and ninety-three patients were included in the study, of whom 81 (27.61%) had some degree of PPM. PPM had no impact on mid-term overall mortality (HR = 1.45; 95% CI = 0.65-3.22; p = 0.36), although it had a negative impact on cardiac events (HR = 11.52; 95% CI = 5.25-25.24; p < 0.001) and functional class (RR = 7.55; 95% CI = 2.59-22.03; p < 0.001). Conclusions Moderate PPM appears to be a strong and independent predictor of cardiac events and advanced functional class in young and middle-aged patients undergoing AVR for severe stenosis. However, it is possible that it has no impact on overall mortality. doi: 10.1111/jocs.12265 (J Card Surg 2014;29:127-133)

AB - Background and Aim The clinical impact of patient-prosthesis mismatch (PPM) on outcomes in young and middle-aged patients undergoing surgery for aortic valve replacement (AVR) remains unknown. Our objective was to examine the mid-term impact of PPM on overall mortality, quality of life, and cardiac events in this population. Methods All patients younger than 70 years of age undergoing isolated AVR from October 2005 to October 2011 were analyzed. PPM was defined as the indexed effective orifice area ≤0.85 cm2/m 2. We studied the impact of PPM on mid-term overall mortality, cardiac events, and New York Heart Association functional class using an analysis stratified for propensity score. Cardiac events were defined as cardiac death, sudden death, hospital readmission due to angina, syncope or heart failure or reoperation on aortic prosthesis. Results Two hundred and ninety-three patients were included in the study, of whom 81 (27.61%) had some degree of PPM. PPM had no impact on mid-term overall mortality (HR = 1.45; 95% CI = 0.65-3.22; p = 0.36), although it had a negative impact on cardiac events (HR = 11.52; 95% CI = 5.25-25.24; p < 0.001) and functional class (RR = 7.55; 95% CI = 2.59-22.03; p < 0.001). Conclusions Moderate PPM appears to be a strong and independent predictor of cardiac events and advanced functional class in young and middle-aged patients undergoing AVR for severe stenosis. However, it is possible that it has no impact on overall mortality. doi: 10.1111/jocs.12265 (J Card Surg 2014;29:127-133)

UR - http://www.scopus.com/inward/record.url?scp=84895516950&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895516950&partnerID=8YFLogxK

U2 - 10.1111/jocs.12265

DO - 10.1111/jocs.12265

M3 - Article

C2 - 24330010

AN - SCOPUS:84895516950

VL - 29

SP - 127

EP - 133

JO - Journal of Cardiac Surgery

JF - Journal of Cardiac Surgery

SN - 0886-0440

IS - 2

ER -