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. 2023 Jul;25(7):1049-1060.
doi: 10.1002/ejhf.2908. Epub 2023 Jun 6.

Prevalence, characteristics and prognostic impact of aortic valve disease in patients with heart failure and reduced, mildly reduced, and preserved ejection fraction: An analysis of the ESC Heart Failure Long-Term Registry

Bahira Shahim  1 , Angiza Shahim  1 , Marianna Adamo  2 , Ovidiu Chioncel  3 , Lina Benson  1 , Maria G Crespo-Leiro  4 , Stefan D Anker  5 , Andrew J S Coats  6 , Gerasimos Filippatos  7 , Mitja Lainscak  8 , Theresa McDonagh  9 , Alexandre Mebazaa  10 , Massimo F Piepoli  11 , Giuseppe M C Rosano  12 , Frank Ruschitzka  13 , Gianluigi Savarese  1 , Petar Seferovic  14 , Maurizio Volterrani  15 , Marisa Crespo Leiro  16 , Javier Segovia Cubero  17 , Offer Amir  18 , Benjamin Palic  19 , Aldo P Maggioni  20 , Marco Metra  2 , Lars H Lund  1
Affiliations
Free article

Prevalence, characteristics and prognostic impact of aortic valve disease in patients with heart failure and reduced, mildly reduced, and preserved ejection fraction: An analysis of the ESC Heart Failure Long-Term Registry

Bahira Shahim et al. Eur J Heart Fail. 2023 Jul.
Free article

Erratum in

Abstract

Aims: To assess the prevalence, clinical characteristics, and outcomes of patients with heart failure (HF) with or without moderate to severe aortic valve disease (AVD) (aortic stenosis [AS], aortic regurgitation [AR], mixed AVD [MAVD]).

Methods and results: Data from the prospective ESC HFA EORP HF Long-Term Registry including both chronic and acute HF were analysed. Of 15 216 patients with HF (62.5% with reduced ejection fraction, HFrEF; 14.0% with mildly reduced ejection fraction, HFmrEF; 23.5% with preserved ejection fraction, HFpEF), 706 patients (4.6%) had AR, 648 (4.3%) AS and 234 (1.5%) MAVD. The prevalence of AS, AR and MAVD was 6%, 8%, and 3% in HFpEF, 6%, 3%, and 2% in HFmrEF and 4%, 3%, and 1% in HFrEF. The strongest associations were observed for age and HFpEF with AS, and for left ventricular end-diastolic diameter with AR. AS (adjusted hazard ratio [HR] 1.43, 95% confidence interval [CI] 1.23-1.67), and MAVD (adjusted HR 1.37, 95% CI 1.07-1.74) but not AR (adjusted HR 1.13, 95% CI 0.96-1.33) were independently associated with the 12-month composite outcome of cardiovascular death and HF hospitalization. The associations between AS and the composite outcome were observed regardless of ejection fraction category.

Conclusions: In the ESC HFA EORP HF Long-Term Registry, one in 10 patients with HF had AVD, with AS and MAVD being especially common in HFpEF and AR being similarly distributed across all ejection fraction categories. AS and MAVD, but not AR, were independently associated with increased risk of in-hospital mortality and 12-month composite outcome, regardless of ejection fraction category.

Keywords: Aortic regurgitation; Aortic stenosis; Aortic valve disease; Ejection fraction; Heart failure; Mixed aortic valve disease.

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References

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