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Association of Thoracic Aorta Calcium Score With Left Ventricular Hypertrophy and Clinical Outcomes in Patients With Severe Aortic Stenosis After Aortic Valve Replacement.

Title
Association of Thoracic Aorta Calcium Score With Left Ventricular Hypertrophy and Clinical Outcomes in Patients With Severe Aortic Stenosis After Aortic Valve Replacement.
Author
허란
Keywords
ISOLATED SYSTOLIC HYPERTENSION; CORONARY-ARTERY CALCIUM; COMPUTED-TOMOGRAPHY; CALCIFICATION; STIFFNESS; DISEASE; IMPACT; STRATIFICATION; INDIVIDUALS; PREDICTION
Issue Date
2017-01
Publisher
ELSEVIER SCIENCE INC
Citation
ANNALS OF THORACIC SURGERY, v. 103, no. 1, page. 74-81
Abstract
Background. Substantial aortic calcification is known to be associated with aortic stiffening and subsequent left ventricular (LV) hypertrophy. This study examined whether the thoracic aorta calcium score (TACS) is related to LV hypertrophy and whether it leads to an adverse prognosis in patients with severe aortic stenosis (AS) after aortic valve replacement (AVR). Methods. We retrospectively reviewed 47 patients (mean age, 64 +/- 11 years) with isolated severe AS who underwent noncontrast computed tomography of the entire thoracic aorta and who received AVR. TACS was quantified using the volume method with values becoming log transformed ((log)[TACS+1]). Transthoracic echocardiography was performed before and 1 year after the operation. Results. Preoperative LV mass index (LVMI) displayed significant positive correlations with male gender (r = 0.430, p = 0.010) and (log)(TACS+1) (r = 0.556, p = 0.003). In multivariate linear regression analysis, only (log)(TACS+1) was independently associated with LVMI, even after adjusting for age, gender, transaortic mean pressure gradient, and coronary or valve calcium score. Independent determinants for postoperative LVMI included (log)(TACS+1) and preoperative LVMI after 1 year of follow-up echocardiography, adjusting for age, gender, indexed effective orifice area, and coronary or valve calcium score. During a median follow-up period of 54 months after AVR, there were 10 events (21%), which included 4 deaths from all-causes, 3 strokes, 2 inpatient admissions for heart failure, and 1 myocardial infarction. The event-free survival rate was significantly lower for patients with TACS of 2,257 mm(3) or higher compared with those whose TACS was lower than 2,257 mm(3) (log-rank p < 0.001). Conclusions. High TACS was associated with increased LVMI among patients with severe AS. Further, high TACS usefully predicted less regression of LVMI and poor clinical outcomes after AVR. TACS may serve as a useful proxy for predicting LV remodeling and adverse prognosis in patients with severe AS undergoing AVR. (C) 2017 by The Society of Thoracic Surgeons
URI
https://www.annalsthoracicsurgery.org/article/S0003-4975(16)30532-X/fulltexthttps://repository.hanyang.ac.kr/handle/20.500.11754/112487
ISSN
0003-4975; 1552-6259
DOI
10.1016/j.athoracsur.2016.05.039
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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