Postoperative Outcomes of Patients with Severe Aortic Regurgitation and Decreased Left Ventricular Ejection Fraction.
10.4070/kcj.2007.37.10.503
- Author:
Chang Hoon LEE
1
;
Jae Kwan SONG
;
Hyung Yong KIM
;
Jung Min AHN
;
Hyun Gu PARK
;
Ji Young LEE
;
Se Hwan LEE
;
Young Hoon JUNG
;
Duk Woo PARK
;
Mi Jung KIM
;
Jong Min SONG
;
Duk Hyun KANG
;
Hyun SONG
;
Cheol Hyun CHUNG
;
Jae Won LEE
;
Meong Gun SONG
Author Information
1. Division of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea. jksong@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Aortic regurgitation;
Ventricular ejection fraction;
Left ventricular dysfunction;
Echocardiography
- MeSH:
Aortic Valve Insufficiency*;
Echocardiography;
Follow-Up Studies;
Heart Failure;
Humans;
Incidence;
Mortality;
Sensitivity and Specificity;
Stroke Volume*;
Survival Rate;
Ventricular Dysfunction, Left
- From:Korean Circulation Journal
2007;37(10):503-509
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: The postoperative outcomes of patients with severe aortic regurgitation (AR) and a low ejection fraction (EF) were elucidated. SUBJECTS AND METHODS: The study group consisted of 201 consecutive patients that underwent corrective surgery for isolated AR. The clinical data of patients with a preoperative EF<50% (n=59, group I) and of patients with an EF> or =50% (n=142, group II) were compared. The clinical follow-up duration was 3.2+/-2.4 years. RESULTS: There was no operative mortality for patients in both groups. Group I patients showed significant improvement of the EF after surgery, from 41+/-6% to 53+/-12% (p<0.001) and the EF (53+/-12 vs 56+/-1%, p=0.09) at follow-up was not significantly different between patients in the two groups. The 5-year survival rate was 70.5+/-8.9% for group I patients and 88.0+/-3.5% for group II patients (p=0.06). The cumulative incidence of congestive heart failure at 5 years was significantly higher in group I patients (32.1+/-9.7% vs 8.5+/-3.1%, p=0.003). Independent determinants of development of congestive heart failure in group I patients were age [hazards ratio (HR)=1.1, 95% confidence interval (CI)=1.02-1.16, p=0.01] and EF (HR=0.82, 95% CI=0.69-0.97, p=0.02). The best cut-off value of the preoperative EF in predicting the development of congestive heart failure was 41.5%, with a sensitivity and specificity of 90.9% and 68.9%, respectively. CONCLUSION: A relatively high 5-year survival rate without operative mortality is anticipated in patients with reduced a preoperative left ventricular ejection fraction (LVEF) and the incidence of congestive heart failure was higher when compared to patients with a normal preoperative LVEF, which could be predicted by the level of the preoperative LVEF.
