0 401

Cited 9 times in

Effect of End-Stage Renal Disease on Rate of Progression of Aortic Stenosis.

 Darae Kim  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  In Jeong Cho  ;  Hyuk-Jae Chang  ;  Jong-Won Ha  ;  Namsik Chung 
 AMERICAN JOURNAL OF CARDIOLOGY, Vol.117(12) : 1972-1977, 2016 
Journal Title
Issue Date
Aged ; Aortic Valve Stenosis/complications* ; Aortic Valve Stenosis/diagnosis ; Aortic Valve Stenosis/physiopathology ; Disease Progression ; Echocardiography, Doppler ; Echocardiography, Transesophageal ; Female ; Follow-Up Studies ; Heart Ventricles/diagnostic imaging* ; Heart Ventricles/physiopathology ; Humans ; Kidney Failure, Chronic/complications* ; Male ; Prognosis ; Retrospective Studies ; Stroke Volume/physiology* ; Ventricular Function, Left/physiology*
This study aimed to investigate the progression of mild-to-moderate aortic stenosis (AS) in patients with end-stage renal disease (ESRD) and determine its metabolic and hemodynamic contributors and clinical outcomes. A total of 74 patients with ESRD (50 men, age 72 ± 11 years) with mild-to-moderate AS were compared with 79 age- and gender-matched controls with normal kidney function. Clinical, laboratory, and echocardiographic features and clinical outcomes including aortic valve (AV) intervention, hospitalization due to heart failure, and cardiovascular death were analyzed. Patients with ESRD were divided into 2 subgroups according to their rate of AV area changes (group 1 [n = 28], rapid progression; and group 2 [n = 46], slow progression). Progression in the degree of AS was noted in 38% of patients with ESRD and 18% of controls (p <0.01) during comparable echocardiographic follow-up durations (29 ± 15 vs 27 ± 24 months, respectively, p = 0.57). In ESRD, patients in group 1 were older (p <0.01) with higher baseline log parathyroid hormone (p <0.01) and larger stroke volume (p = 0.03) than those in group 2. During clinical follow-up (48 ± 23 months), patients in group 1 showed poorer clinical outcomes than those in group 2 and controls (log-rank p <0.01). Age, left atrial volume index ≥42 ml/m(2), and annual increases of peak pressure gradient across the AV (mm Hg/year) demonstrated additive predictive values for prognosis. AS in ESRD progresses in an accelerated manner along with higher metabolic and hemodynamic loads on AV compared with those with normal kidney function. Accelerated progression of mild-to-moderate AS in ESRD results in poor prognosis.
Full Text
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Da Rae(김다래)
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Chung, Nam Sik(정남식)
Cho, In Jeong(조인정)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.