Severe mitral stenosis as a cause of paradoxical low-flow, low-gradient severe aortic stenosis: an explorative study on hemodynamics and outcomes

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F25%3A10505908" target="_blank" >RIV/00064165:_____/25:10505908 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11110/25:10505908

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=_sSZN15ZmB" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=_sSZN15ZmB</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3389/fcvm.2025.1634914" target="_blank" >10.3389/fcvm.2025.1634914</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Severe mitral stenosis as a cause of paradoxical low-flow, low-gradient severe aortic stenosis: an explorative study on hemodynamics and outcomes

Popis výsledku v původním jazyce

Background: Aortic stenosis (AS) and mitral stenosis (MS) are valvular heart diseases that may present concomitantly, particularly in regions where rheumatic heart disease remains prevalent. While each condition has been extensively studied in isolation, there is limited data on the clinical characteristics of patients with combined AS-MS. Methods: We retrospectively identified patients with significant AS and concomitant significant MS from the echocardiography database between 2003 and 2018. Exclusion criteria included left ventricular ejection fraction &lt;50%, other significant valvular lesions, prior cardiac surgery, and associated congenital heart disease. Patients with isolated AS were compared to patients with combined AS-MS. Results: Of 1470 patients with severe AS, a total of 353 patients were included: 41 with combined AS-MS and 312 with isolated AS. The prevalence of combined AS-MS was 11% among patients with significant AS. Compared to patients with isolated AS, patients with combined AS-MS were significantly younger (50 vs. 63 years, p &lt; 0.001), had a lower prevalence of hypertension (44% vs. 64%, P = 0.017) and diabetes (22% v. 42%, p = 0.013), and a greater prevalence of atrial fibrillation (17% vs. 5%, p = 0.003). Patients with combined AS-MS had a significantly larger left atrial size (4.79 +/- 0.70 cm vs. 3.93 +/- 0.73 cm, p &lt; 0.001), higher peak tricuspid velocities (3.14 +/- 0.59 m/s vs. 2.72 +/- 0.45 m/s, p &lt; 0.001), and greater prevalence of moderate or severe tricuspid regurgitation (15% vs. 1%, p &lt; 0.001). Echocardiographic parameters assessing transvalvular flow rate did not differ significantly between the two groups. After multivariate adjustment for age and gender combined AS-MS was associated with worse 5-year overall survival (HR 2.672, 95% CI 1.060-6.732, p = 0.037). Conclusion: Combined mitral and aortic stenosis is not uncommon (11%) but linked to worse outcomes than isolated AS. Despite expectations, concomitant significant MS did not increase prevalence of paradoxical low-flow, low-gradient AS.

Název v anglickém jazyce

Severe mitral stenosis as a cause of paradoxical low-flow, low-gradient severe aortic stenosis: an explorative study on hemodynamics and outcomes

Popis výsledku anglicky

Background: Aortic stenosis (AS) and mitral stenosis (MS) are valvular heart diseases that may present concomitantly, particularly in regions where rheumatic heart disease remains prevalent. While each condition has been extensively studied in isolation, there is limited data on the clinical characteristics of patients with combined AS-MS. Methods: We retrospectively identified patients with significant AS and concomitant significant MS from the echocardiography database between 2003 and 2018. Exclusion criteria included left ventricular ejection fraction &lt;50%, other significant valvular lesions, prior cardiac surgery, and associated congenital heart disease. Patients with isolated AS were compared to patients with combined AS-MS. Results: Of 1470 patients with severe AS, a total of 353 patients were included: 41 with combined AS-MS and 312 with isolated AS. The prevalence of combined AS-MS was 11% among patients with significant AS. Compared to patients with isolated AS, patients with combined AS-MS were significantly younger (50 vs. 63 years, p &lt; 0.001), had a lower prevalence of hypertension (44% vs. 64%, P = 0.017) and diabetes (22% v. 42%, p = 0.013), and a greater prevalence of atrial fibrillation (17% vs. 5%, p = 0.003). Patients with combined AS-MS had a significantly larger left atrial size (4.79 +/- 0.70 cm vs. 3.93 +/- 0.73 cm, p &lt; 0.001), higher peak tricuspid velocities (3.14 +/- 0.59 m/s vs. 2.72 +/- 0.45 m/s, p &lt; 0.001), and greater prevalence of moderate or severe tricuspid regurgitation (15% vs. 1%, p &lt; 0.001). Echocardiographic parameters assessing transvalvular flow rate did not differ significantly between the two groups. After multivariate adjustment for age and gender combined AS-MS was associated with worse 5-year overall survival (HR 2.672, 95% CI 1.060-6.732, p = 0.037). Conclusion: Combined mitral and aortic stenosis is not uncommon (11%) but linked to worse outcomes than isolated AS. Despite expectations, concomitant significant MS did not increase prevalence of paradoxical low-flow, low-gradient AS.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Frontiers in Cardiovascular Medicine

ISSN

2297-055X

e-ISSN

2297-055X

Svazek periodika

12

Číslo periodika v rámci svazku

October

Stát vydavatele periodika

CH - Švýcarská konfederace

Počet stran výsledku

11

Strana od-do

1634914

Kód UT WoS článku

001619121000001

EID výsledku v databázi Scopus

2-s2.0-105022656846