Key result
Pre-operative restrictive LV filling (HR 1.77, P=0.033) and raised peak systolic pulmonary artery pressure >45 mmHg (HR 2.71, P=0.010) independently predicted 4-year mortality after AVR.
Cohort (n=86)
Hazard Ratio: 2.71
p-value: p=0.010
In patients with low-flow, high-gradient aortic stenosis and LV dysfunction, the severity of pre-operative systolic and diastolic LV dysfunction strongly predicts mortality following aortic valve replacement.
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May refine pre-AVR risk stratification in low-flow AS with LV dysfunction; hypothesis-generating and requires prospective validation.
Lam et al. (2009) conducted a cohort in Low-flow and high-gradient aortic stenosis with left ventricular dysfunction (n=86). Pre-operative systolic and diastolic LV dysfunction (restrictive filling, raised PSPAP) was evaluated on 4-year mortality (HR 2.71, p=0.010). Pre-operative restrictive LV filling (HR 1.77, P=0.033) and raised peak systolic pulmonary artery pressure >45 mmHg (HR 2.71, P=0.010) independently predicted 4-year mortality after AVR.
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