Patients with multiple left-sided native valvular heart disease had higher mortality and more heart failure at 6 months compared to those with single VHD (HR 1.62 and HR 1.72).
Does multiple native valvular heart disease reduce 6-month survival compared to single native valvular heart disease in patients with severe left-sided VHD?
Multiple native valvular heart disease affects nearly 30% of patients with severe left-sided VHD and is associated with higher 6-month mortality and heart failure rates, despite lower rates of surgical intervention.
Tasa de eventos absoluta: 0% vs 0%
Abstract Aims To assess the characteristics, management, and survival of patients with multiple native valvular heart disease (VHD). Methods and results Among the 5087 patients with ≥1 severe left-sided native VHD included in the EURObservational VHD II Survey (maximum 3-month recruitment period per centre between January and August 2017 with a 6-month follow-up), 3571 had a single left-sided VHD (Group A, 70.2%), 363 had one severe left-sided VHD with moderate VHD of the other ipsilateral valve (Group B, 7.1%), and 1153 patients (22.7%) had ≥2 severe native VHDs (left-sided and/or tricuspid regurgitation, Group C). Patients with multiple VHD (Groups B and C) were more often women, had greater congestive heart failure (CHF) and comorbidity, higher left atrial volumes and pulmonary pressures, and lower ejection fraction than Group A patients (all P ≤ 0.01). During the index hospitalization, 36.7% of Group A (n = 1312), 26.7% of Group B (n = 97), and 32.7% of Group C (n = 377) underwent valvular intervention (P 0.001). Six-month survival was better for Group A than for Group B or C (both P 0.001), even after adjustment for age, sex, body mass index, and Charlson index hazard ratio (HR) 95% confidence interval (CI) 1.62 (1.10–2.38) vs. Group B and HR 95% CI 1.72 (1.32–2.25) vs. Group C. Groups B and C had more CHF at 6 months than Group A (both P 0.001). Factors associated with mortality in Group C were age, CHF, and comorbidity (all P 0.010). Conclusion Multiple VHD is common, encountered in nearly 30% of patients with left-sided native VHD, and associated with greater cardiac damage and leads to higher mortality and more heart failure at 6 months than single VHD, yet with lower rates of surgery.
This journal scan highlights a study on endotype-guided therapy for patients with angina and no obstructive coronary artery disease (ANOCA), a challenging clinical problem. The concept of personalized medicine based on underlying pathophysiology is a key area of research.
Tribouilloy et al. (Thu,) reported a other. Patients with multiple left-sided native valvular heart disease had higher mortality and more heart failure at 6 months compared to those with single VHD (HR 1.62 and HR 1.72).