INTRODUCTION: Management of aortic stenosis (AS) in patients with chronic kidney disease (CKD) may often be overlooked, and this could confer poorer outcomes. METHODS: Consecutive patients ( n = 727) with index echocardiographic diagnosis of moderate to severe AS (aortic valve area <1.5 cm 2 ) were examined. They were divided into those with CKD (estimated glomerular filtration rate < 60 mL/min) and those without. Baseline clinical and echocardiographic parameters were compared, and a multivariate Cox regression model was constructed. Clinical outcomes were compared using Kaplan-Meier curves. RESULTS: There were 270 (37.1%) patients with concomitant CKD. The CKD group was older (78.0 ± 10.3 vs. 72.1 ± 12.9 years, P < 0.001), with a higher prevalence of hypertension, diabetes mellitus, hyperlipidaemia and ischaemic heart disease. AS severity did not differ significantly, but left ventricular (LV) mass index (119.4 ± 43.7 vs. 112.3 ± 40.6 g/m 2 , P = 0.027) and Doppler mitral inflow E to annular tissue Doppler e' ratio (E: e' 21.5 ± 14.6 vs. 17.8 ± 12.2, P = 0.001) were higher in the CKD group. There was higher mortality (log-rank 51.5, P < 0.001) and more frequent admissions for cardiac failure (log-rank 25.9, P < 0.001) in the CKD group, with a lower incidence of aortic valve replacement (log-rank 7.12, P = 0.008). On multivariate analyses, after adjusting for aortic valve area, age, left ventricular ejection fraction and clinical comorbidities, CKD remained independently associated with mortality (hazard ratio 1.96, 95% confidence interval 1.50-2.57, P < 0.001). CONCLUSION Concomitant CKD in patients with moderate to severe AS was associated with increased mortality, more frequent admissions for cardiac failure and a lower incidence of aortic valve replacement.
Humans ; Aortic Valve Stenosis/surgery* ; Male ; Female ; Renal Insufficiency, Chronic/complications* ; Aged ; Aged, 80 and over ; Middle Aged ; Severity of Illness Index ; Glomerular Filtration Rate ; Proportional Hazards Models ; Echocardiography ; Kaplan-Meier Estimate ; Retrospective Studies ; Aortic Valve/surgery* ; Echocardiography, Doppler

RELIABILITY AND VALIDATION OF THE MALAY VERSION OF THE GENDER EQUITABLE MEN SCALE QUESTIONNAIRE Gender role beliefs refer to individuals’ belief that men and women should shoulder their role-related behaviour. Evidence showed that patriarchal gender roles are directly associated with violence perpetration. Gender roles can be measured with the GEMS questionnaire, which was developed in English. Thus, it needs to be adapted to the local language to be used in a family violence study among married men in Sarawak, Malaysia. This study aims to translate and validate the original English version of the GEMS into the Malay language. The English version was translated forward and backward into Malay, followed by content validation by six public health and language experts. The scale was further tested for face validity among 30 people from the general population, followed by a cross-sectional study involving 200 male respondents. The item-level content validity index (I-CVI) ranges from 0.83 to 1. Exploratory factor analysis resulted in three components within the scale, and confirmatory factor analysis established convergent and discriminant validity. The overall Cronbach’s alpha ranged from 0.778 to 0.921. In conclusion, the Malay version of the GEMS is a valid and reliable tool for measuring gender equitability among men in Sibu, Sarawak.