Concomitant Mitral Regurgitation in Severe Aortic Stenosis-A Report From the CURRENT AS Registry

被引：3

作者：

Murai, Ryosuke ^{[1
]}

Kawase, Yuichi ^{[1
]}

Taniguchi, Tomohiko ^{[3
]}

Morimoto, Takeshi ^{[5
]}

Kadota, Kazushige ^{[1
]}

Ohya, Masanobu ^{[1
]}

Shimada, Takenobu ^{[1
]}

Maruo, Takeshi ^{[1
]}

Fuku, Yasushi ^{[1
]}

Komiya, Tatsuhiko ^{[2
]}

Ando, Kenji ^{[3
]}

Hanyu, Michiya ^{[4
]}

Kanamori, Norio ^{[6
]}

Aoyama, Takeshi ^{[6
]}

Murata, Koichiro ^{[7
]}

Onodera, Tomoya ^{[7
]}

Yamazaki, Fumio ^{[8
]}

Kitai, Takeshi ^{[9
]}

Furukawa, Yutaka ^{[9
]}

Koyama, Tadaaki ^{[9
]}

Miyake, Makoto ^{[10
]}

Izumi, Chisato ^{[12
]}

Nakagawa, Yoshihisa ^{[13
]}

Yamanaka, Kazuo ^{[11
]}

Mitsuoka, Hirokazu ^{[14
]}

Shirotani, Manabu ^{[14
]}

Kato, Masashi ^{[15
]}

Miki, Shinji ^{[15
]}

Nakajima, Hiroyuki ^{[16
]}

Hirano, Yutaka ^{[17
]}

Miyazaki, Shunichi ^{[17
]}

Saga, Toshihiko ^{[18
]}

Sugioka, Sachiko ^{[19
]}

Matsuda, Shintaro ^{[19
]}

Matsuda, Mitsuo ^{[19
]}

Ogawa, Tatsuya ^{[20
]}

Nagao, Kazuya ^{[21
]}

Inada, Tsukasa ^{[21
]}

Nakayama, Shogo ^{[22
]}

Mabuchi, Hiroshi ^{[23
]}

Takeuchi, Yasuyo ^{[24
]}

Sakamoto, Hiroki ^{[24
]}

Sakaguchi, Genichi ^{[25
]}

Yamane, Keiichiro ^{[26
]}

Eizawa, Hiroshi ^{[26
]}

Toyofuku, Mamoru ^{[27
]}

Tamura, Takashi ^{[27
]}

Iwakura, Atsushi ^{[28
]}

Ishii, Mitsuru ^{[29
]}

Akao, Masaharu ^{[29
]}

机构：

[1] Kurashiki Cent Hosp, Dept Cardiol, Kurashiki, Okayama, Japan

[2] Kurashiki Cent Hosp, Dept Cardiovasc Surg, Kurashiki, Okayama, Japan

[3] Kokura Mem Hosp, Div Cardiol, Kitakyushu, Fukuoka, Japan

[4] Kokura Mem Hosp, Dept Cardiovasc Surg, Kitakyushu, Fukuoka, Japan

[5] Hyogo Coll Med, Dept Clin Epidemiol, Nishinomiya, Hyogo, Japan

[6] Shimada Municipal Hosp, Div Cardiol, Shimada, Japan

[7] Shizuoka City Shizuoka Hosp, Dept Cardiol, Shizuoka, Japan

[8] Shizuoka City Shizuoka Hosp, Dept Cardiovasc Surg, Shizuoka, Japan

[9] Kobe City Med Ctr Gen Hosp, Dept Cardiovasc Med, Kobe, Hyogo, Japan

[10] Tenri Hosp, Dept Cardiol, Tenri, Nara, Japan

[11] Tenri Hosp, Dept Cardiovasc Surg, Tenri, Nara, Japan

[12] Natl Cerebral & Cardiovasc Ctr, Div Heart Failure, Suita, Osaka, Japan

[13] Shiga Univ Med Sci, Dept Cardiovasc Med, Otsu, Shiga, Japan

[14] Kinki Univ, Div Cardiol, Fac Med, Ikoma, Japan

[15] Mitsubishi Kyoto Hosp, Dept Cardiol, Kyoto, Japan

[16] Mitsubishi Kyoto Hosp, Dept Cardiovasc Surg, Kyoto, Japan

[17] Kindai Univ Hosp, Dept Cardiol, Osakasayama, Japan

[18] Kindai Univ Hosp, Dept Cardiovasc Surg, Osakasayama, Japan

[19] Kishiwada City Hosp, Dept Cardiol, Kishiwada, Japan

[20] Kishiwada City Hosp, Dept Cardiovasc Surg, Kishiwada, Japan

[21] Osaka Red Cross Hosp, Dept Cardiovasc Ctr, Osaka, Japan

[22] Osaka Red Cross Hosp, Dept Cardiovasc Surg, Osaka, Japan

[23] Koto Mem Hosp, Dept Cardiol, Higashiomi, Japan

[24] Shizuoka Prefectural Gen Hosp, Dept Cardiol, Shizuoka, Japan

[25] Shizuoka Prefectural Gen Hosp, Dept Cardiovasc Surg, Shizuoka, Japan

[26] Nishikobe Med Ctr, Dept Cardiol, Kobe, Hyogo, Japan

[27] Japanese Red Cross Wakayama Med Ctr, Dept Cardiol, Wakayama, Japan

[28] Japanese Red Cross Wakayama Med Ctr, Dept Cardiovasc Surg, Wakayama, Japan

[29] Natl Hosp Org Kyoto Med Ctr, Dept Cardiol, Kyoto, Japan

[30] Natl Hosp Org Kyoto Med Ctr, Dept Cardiovasc Surg, Kyoto, Japan

[31] Kyoto Univ, Dept Cardiovasc Med, Grad Sch Med, Kyoto, Japan

[32] Kitano Hosp, Cardiovasc Ctr, Tazuke Kofukai Med Res Inst, Osaka, Japan

[33] Kitano Hosp, Cardiovasc Ctr, Tazuke Kofukai Med Res Inst, Dept Cardiovasc Surg, Osaka, Japan

[34] Hikone Municipal Hosp, Dept Cardiol, Hikone, Japan

[35] Kansai Elect Power Hosp, Dept Cardiol, Osaka, Japan

[36] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Cardiol, Amagasaki, Hyogo, Japan

[37] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Cardiovasc Surg, Amagasaki, Hyogo, Japan

[38] Saiseikai Noe Hosp, Dept Cardiol, Osaka, Japan

[39] Shiga Gen Hosp, Dept Cardiol, Moriyama, Japan

[40] Shiga Gen Hosp, Dept Cardiovasc Surg, Moriyama, Japan

[41] Hamamatsu Rosai Hosp, Dept Cardiol, Hamamatsu, Shizuoka, Japan

[42] Hamamatsu Rosai Hosp, Dept Cardiovasc Surg, Hamamatsu, Shizuoka, Japan

[43] Japanese Red Cross Otsu Hosp, Dept Cardiol, Otsu, Shiga, Japan

[44] Japanese Red Cross Otsu Hosp, Dept Cardiovasc Surg, Otsu, Shiga, Japan

[45] Hirakata Kohsai Hosp, Dept Cardiol, Hirakata, Osaka, Japan

[46] Kyoto Univ, Dept Cardiovasc Surg, Grad Sch Med, Kyoto, Japan

来源：

CIRCULATION JOURNAL | 2022年 / 86卷 / 03期

关键词：

Aortic stenosis; Aortic valve replacement; Mitral regurgitation; NATIVE VALVULAR REGURGITATION; STAGING CARDIAC DAMAGE; END-POINT DEFINITIONS; VALVE-REPLACEMENT; HEART-DISEASE; TRANSCATHETER; IMPLANTATION; EVOLUTION; IMPACT; RECOMMENDATIONS;

D O I：

10.1253/circj.CJ-21-0054

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The clinical significance of concomitant mitral regurgitation (MR) has not been well addressed in patients with severe aortic stenosis (AS). Methods and Results: We analyzed 3,815 patients from a retrospective multicenter registry of severe AS in Japan (CURRENT AS registry). We compared the clinical outcomes between patients with moderate/severe MR and with none/mild MR according to the initial treatment strategy (initial aortic valve replacement [AVR] or conservative strategy). The primary outcome measure was a composite of aortic valve-related death or heart failure hospitalization. At baseline, moderate/severe MR was present in 227/1,197 (19%) patients with initial AVR strategy and in 536/2,618 (20%) patients with a conservative strategy. The crude cumulative 5-year incidence of the primary outcome measure was significantly higher in patients with moderate/severe MR than in those with none/ mild MR, regardless of the initial treatment strategy (25.2% vs. 14.4%, P<0.001 in the initial AVR strategy, and 63.3% vs. 40.7%, P<0.001 in the conservative strategy). After adjusting confounders, moderate/severe MR was not independently associated with higher risk for the primary outcome measure in the initial AVR strategy (hazard ratio [HR] 1.11, 95% confidence interval [CI] 0.67- 1.83, P=0.69), and in the conservative strategy (HR 1.13, 95% CI 0.93-1.37, P=0.22). Conclusions: Concomitant moderate/severe MR was not independently associated with higher risk for the primary outcome mea-sure regardless of the initial treatment strategy.

引用

页码：427 / +

页数：19

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