背景:尽管主动脉瓣狭窄(AS)与心脏损伤(CD)密切相关,目前尚不清楚CD是否仅限于中度和重度AS患者,以及哪些因素会影响其进展.尽管瓣膜血流动力学状态的改变可能导致AS中CD的发展,常见的合并症可能有贡献。
目的:本研究的目的是确定轻度AS患者CD的患病率及其相关因素。
方法:这项回顾性研究包括2010年至2021年的9,611例轻度AS患者(主动脉瓣峰值速度[Vmax]2-3m/s和主动脉瓣异常描述)。CD使用Genereux分类进行分级。
结果:除20%(n=1,901;0期)的轻度AS患者表现为CD:1,613(17%)1期,4,843(50%)2期,891(9%)3期和363(4%)4期。分期较高的患者有更多的合并症(高血压,心力衰竭,缺血性心脏病,中风,外周动脉疾病,慢性肾病,慢性肺病,和糖尿病),但瓣膜血流动力学状态与无CD相似。CD阶段没有随着更高的Vmax范围而恶化(阶段>1,64%的Vmax<2.5m/s,比61%的Vmax≥2.5m/s),但随着合并症的数量而增加,阶段>1发生在50%,53%,60%,66%,72%,在存在0、1、2、3、4和5或更多合并症的情况下,为73%,分别。
结论:CD在轻度AS患者中非常普遍。在轻度AS患者中,CD的程度和AS的严重程度之间没有关系;相反,CD与合并症高度相关。
BACKGROUND: Despite the close association between aortic stenosis (AS) and cardiac damage (CD), it is unclear if CD is limited to patients with moderate and severe AS and which factors affect its progression. Although altered valvular hemodynamic status may drive the development of CD in AS, commonly occurring comorbidities may contribute.
OBJECTIVE: The aim of this study was to determine the prevalence of and factors associated with CD in mild AS.
METHODS: This retrospective study included 9,611 patients with mild AS (peak aortic valve velocity [Vmax] 2-3 m/s and description of abnormal aortic valve) from 2010 through 2021. CD was staged using the Genereux classification.
RESULTS: All but 20% (n = 1,901; stage 0) of patients with mild AS demonstrated CD: 1,613 (17%) stage 1, 4,843 (50%) stage 2, 891 (9%) stage 3, and 363 (4%) stage 4. Patients with higher stages had more comorbidities (hypertension, heart failure, ischemic heart disease, stroke, peripheral arterial disease, chronic kidney disease, chronic pulmonary disease, and diabetes mellitus) but had valvular hemodynamic status similar to those without CD. CD stage did not worsen with higher Vmax range (stage >1 in 64% with Vmax <2.5 m/s vs 61% with Vmax ≥2.5 m/s) but increased with the number of comorbidities, with stage >1 occurring in 50%, 53%, 60%, 66%, 72%, and 73% in the presence of 0, 1, 2, 3, 4, and 5 or more comorbidities, respectively.
CONCLUSIONS: CD was highly prevalent in patients with mild AS. Among patients with mild AS, there was no relationship between the degree of CD and AS severity; instead, CD was highly associated with comorbidities.