Heart (British Cardiac Society) · 2026
Early predictors of aortic valve surgery in patients with significant bicuspid aortic regurgitation without initial surgical indication.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lim Ha Jeong, Kim Kyu, Gwak Seo-Yeon, Lee Hyun-Jung, Cho Iksung, Hong Geu-Ru, Ha Jong-Won, Shim Chi Young
Аннотация
BACKGROUND: Bicuspid aortic regurgitation (AR) is common in younger patients who often do not meet guideline-based criteria for aortic valve (AV) surgery at diagnosis. However, identifying early predictors of disease progression may aid in risk stratification and surgical timing.
METHODS: From a single-centre registry of 1927 patients with bicuspid AV, we identified 335 patients with moderate or severe AR, excluding those with severe aortic stenosis (AS), endocarditis or other major valvular diseases. Among them, 199 patients (mean age 52±14.0 years; 80% male) did not initially meet the surgical criteria and were included in the final analysis. Clinical data and echocardiographic parameters, including speckle-tracking-derived strain measurements, were analysed. The primary outcome was progression to AV surgery during follow-up.
RESULTS: Over a mean follow-up of 4.9 years, 41 patients (21%) underwent AV surgery, primarily for symptom onset or left ventricular (LV) enlargement. In multivariable Cox regression, three independent predictors of future surgery were identified: LV mass index ≥113 g/m² (HR 4.49, 95% CI 1.74 to 11.6, p=0.002), left atrial (LA) reservoir strain <28% (HR 3.07, 95% CI 1.40 to 6.74, p=0.005) and concomitant moderate AS (HR 3.19, 95% CI 1.40 to 7.28, p=0.006).
CONCLUSION: In patients with significant bicuspid AR who do not initially meet indications for AV surgery, increased LV mass index, impaired LA reservoir strain and concomitant moderate AS are early predictors of surgical progression. These parameters may enhance surveillance strategies and inform earlier surgical referral in selected patients.
METHODS: From a single-centre registry of 1927 patients with bicuspid AV, we identified 335 patients with moderate or severe AR, excluding those with severe aortic stenosis (AS), endocarditis or other major valvular diseases. Among them, 199 patients (mean age 52±14.0 years; 80% male) did not initially meet the surgical criteria and were included in the final analysis. Clinical data and echocardiographic parameters, including speckle-tracking-derived strain measurements, were analysed. The primary outcome was progression to AV surgery during follow-up.
RESULTS: Over a mean follow-up of 4.9 years, 41 patients (21%) underwent AV surgery, primarily for symptom onset or left ventricular (LV) enlargement. In multivariable Cox regression, three independent predictors of future surgery were identified: LV mass index ≥113 g/m² (HR 4.49, 95% CI 1.74 to 11.6, p=0.002), left atrial (LA) reservoir strain <28% (HR 3.07, 95% CI 1.40 to 6.74, p=0.005) and concomitant moderate AS (HR 3.19, 95% CI 1.40 to 7.28, p=0.006).
CONCLUSION: In patients with significant bicuspid AR who do not initially meet indications for AV surgery, increased LV mass index, impaired LA reservoir strain and concomitant moderate AS are early predictors of surgical progression. These parameters may enhance surveillance strategies and inform earlier surgical referral in selected patients.