Table 6.
Demographic, clinical, and echocardiographic characteristics of patients with severe AR
| Characteristic | Severe AR | |||
|---|---|---|---|---|
| Total (n = 222) | Conservative (n = 161) | Intervention (n = 61) | P-value | |
| Clinical characteristic | ||||
| Age (yr) | 65.8 ± 14.1 | 65.8 ± 14.7 | 65.3 ± 12.9 | 0.812 |
| Male sex | 138 (62.7) | 61 (37.9) | 21 (34.4) | 0.748 |
| Body mass index (kg/m2) | 23.2 ± 3.7 | 23.0 ± 3.7 | 23.8 ± 3.4 | 0.170 |
| NYHA class ≥ 2 | 129 (58.1) | 83 (51.5) | 47 (77.0) | 0.001* |
| Hypertension | 135 (60.8) | 99 (61.5) | 37 (60.7) | 0.815 |
| Diabetes | 26 (11.7) | 18 (11.2) | 8 (13.1) | 0.768 |
| Dyslipidemia | 38 (17.1) | 33 (20.5) | 5 (8.2) | 0.059 |
| Atrial fibrillation | 37 (16.7) | 28 (17.4) | 10 (16.4) | 0.999 |
| Chronic dialysis | 7 (3.2) | 4 (2.5) | 3 (4.9) | 0.450 |
| Chronic pulmonary disease | 13 (5.9) | 9 (5.6) | 4 (6.6) | 0.661 |
| Previous MI | 7 (3.2) | 5 (3.1) | 2 (3.3) | 0.681 |
| Hemoglobin (g/dL) | 12.4 ± 2.3 | 12.5 ± 2.3 | 12.3 ± 2.2 | 0.649 |
| Creatinine (mg/dL) | 1.2 ± 1.2 | 1.2 ± 1.2 | 1.2 ± 1.0 | 0.966 |
| Creatinine clearance (mL/min) | 71.5 ± 27.1 | 71.3 ± 28.9 | 73.1 ± 22.9 | 0.709 |
| NT-proBNP (pg/mL) | 7,714.0 ± 11,142.0 | 8,993.9 ± 12,357.4 | 4,361.4 ± 6,076.6 | 0.033* |
| Echocardiographic characteristic | ||||
| LVEDD (mm) | 61.6 ± 7.9 | 60.1 ± 7.4 | 65.4 ± 8.0 | < 0.001* |
| LVESD (mm) | 43.2 ± 8.5 | 41.8 ± 7.9 | 46.7 ± 9.2 | < 0.001* |
| > 50 | 40 (18.0) | 21 (13.0) | 19 (31.1) | 0.003* |
| LVEF (%) | 54.7 ± 11.5 | 55.8 ± 10.9 | 51.6 ± 12.5 | 0.014* |
| ≤ 55 | 88 (39.6) | 55 (34.2) | 33 (54.1) | 0.011* |
| LVESD > 50 mm or LVEF ≤ 55% | 93 (41.9) | 58 (36.0) | 35 (57.4) | 0.006* |
| LV mass index (g/m2) | 163.5 ± 46.4 | 158.0 ± 47.0 | 178.2 ± 41.8 | 0.004* |
| TR Vmax (m/sec) | 2.6 ± 0.6 | 2.5 ± 0.5 | 2.8 ± 0.7 | 0.008* |
| LA volume index (mL/m2) | 56.1 ± 30.2 | 52.5 ± 25.8 | 67.1 ± 39.1 | 0.030* |
| AR etiology | < 0.001* | |||
| Degenerative | 112 (50.4) | 90 (55.9) | 22 (36.1) | |
| Rheumatic | 12 (5.4) | 10 (6.2) | 2 (3.3) | |
| Congenital | 35 (15.8) | 28 (17.4) | 7 (11.5) | |
| Aorta pathology | 26 (11.7) | 14 (8.7) | 12 (19.7) | |
| Endocarditis | 10 (4.5) | 3 (1.9) | 7 (11.5) | |
| Other | 25 (11.3) | 14 (8.7) | 11 (18.0) | |
| AR jet width to LVOT ratio (central jet) | 0.827 | |||
| Mild (< 25) | 2 (1.5) | 1 (1.1) | 1 (2.4) | |
| Moderate (25–64) | 47 (34.6) | 33 (34.7) | 14 (34.1) | |
| Severe (≥ 65) | 87 (64.0) | 61 (64.2) | 26 (63.4) | |
| AR jet CSA/LVOT CSA (central jet) | 0.502 | |||
| Mild (5–20) | 6 (6.6) | 5 (7.2) | 1 (4.5) | |
| Moderate (21–59) | 24 (26.4) | 20 (29.0) | 4 (18.2) | |
| Severe (≥ 60) | 61 (67.0) | 44 (63.8) | 17 (77.3) | |
| AR PHT (msec) | 366.9 ± 132.2 | 380.6 ± 122.9 | 324.8 ± 152.2 | 0.056 |
| AR vena contracta width (cm) | 0.64 ± 0.16 | 0.64 ± 0.15 | 0.65 ± 0.19 | 0.673 |
| Regurgitant volume (mL/beat) | 65.8 ± 27.2 | 66.2 ± 30.0 | 64.7 ± 17.5 | 0.897 |
| Regurgitant fraction (%) | 47.3 ± 12.0 | 44.7 ± 12.2 | 56.5 ± 6.4 | 0.244 |
| EROA (cm2) | 0.36 ± 0.15 | 0.35 ± 0.16 | 0.41 ± 0.14 | 0.393 |
| DTA diastolic flow reversal | 140 (95.2) | 95 (94.1) | 45 (97.8) | 0.564 |
| Treatment strategy | - | |||
| Mechanical AVR | 27 (12.2) | 0 (0) | 27 (44.3) | |
| Bioprosthetic AVR | 28 (12.6) | 0 (0) | 28 (45.9) | |
| AV surgical repair | 3 (1.3) | 0 (0) | 3 (4.9) | |
| TAVR | 3 (1.3)a | 0 (0) | 3 (4.9) | |
| In-hospital mortality | 8 (3.6) | 3 (1.9) | 5 (8.2) | 0.063 |
| Cardiac | 2 (0.9) | 2 (1.2) | 0 (0) | |
| Noncardiac | 3 (1.4) | 1 (0.6) | 2 (3.2) | |
| Unknown | 3 (1.4) | 0 (0) | 3 (4.9) | |
Values are presented as mean ± standard deviation or number (%)
AR aortic regurgitation, NYHA New York Heart Association, MI myocardial infarction, NT-proBNP N-terminal pro B-type natriuretic peptide, LVEDD left ventricular end-diastolic dimension, LVESD left ventricular end-systolic dimension, LVEF left ventricular ejection fraction, LV left ventricle, TR tricuspid regurgitation, Vmax maximal velocity, LA left atrium, LVOT left ventricular outflow tract, CSA cross-sectional area, PHT pressure half-time, EROA effective regurgitant orifice area, DTA descending thoracic aorta, AVR aortic valve replacement, TAVR transcutaneous aortic valve replacement
aAR cases combined with aortic stenosis underwent TAVR
*P < 0.05