Impact of Right Ventricular Systolic Dysfunction on Outcome in Aortic Stenosis

Bohbot, Yohann
Guignant, Pierre
Rusinaru, Dan
Kubala, Maciej
Marechaux, Sylvestre
Tribouilloy, Christophe

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Publication date

January 2020

DOI

10.1161/CIRCIMAGING.119.009802

Publisher

Ovid Technologies (Wolters Kluwer Health)

Abstract

International audienceBACKGROUND: Pulmonary hypertension is an established outcome predictor in patients with aortic stenosis (AS), but the prognostic impact of right ventricular dysfunction has not been well studied. METHODS: We included 2181 patients (50.4% men; mean age, 77 years) with aortic valve area 24 mm (overall P= 17 mm (adjusted HR, 0.23 [95% CI, 0.16-0.34] for TAPSE = 17 mm; P for interaction, 0.97). CONCLUSIONS: Right ventricular dysfunction is an important and independent predictor of mortality in AS. TAPSE <17 mm at the time of AS diagnosis is a marker of poor survival under conservative management and after AVR even in asymptomatic patients with severe AS. AVR was associated with a pronounced reduction in mortality independe...