Publication: Estenosis aórtica severa en la vida real. Determinantes del manejo y pronóstico
Loading...
Files
Official URL
Full text at PDC
Publication Date
2018-05-04
Authors
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad Complutense de Madrid
Citations
Exportar
Abstract
La estenosis aórtica (EAo) es la enfermedad valvular cardíaca más común en los países desarrollados y tiene un mal pronóstico cuando aparecen los síntomas. Según las guías de práctica clínica la sustitución valvular aórtica (SVAo) es el tratamiento de elección para la EAo severa sintomática. La implantación de válvula aórtica transcatéter (TAVI), presenta buenos resultados a corto y mediano plazo de seguimiento, por lo que cada vez más juega un papel preponderante como opción de tratamiento en los pacientes con EAo severa sintomática. A pesar de las opciones actuales, muchos de los pacientes con EAo severa sintomática son manejados con medicamentos. Nuestro objetivo fue evaluar los determinantes en el manejo y pronóstico de la EAo severa en la vida real. Métodos: Registro multicéntrico (en 48 centros españoles) que incluyó a todos los adultos con EAo severa (gradiente medio≥40 mmHg o área valvular aórtica (AVA) <1 cm2 estimada por ecuación de continuidad, sin intervención valvular previa) diagnosticados por ecocardiograma transtorácico durante el mes de enero de 2014. Se registraron las características clínicas, datos ecocardiográficos, índice de comorbilidad de Charlson, así como el European System for Cardiac Operative Risk Evaluation (EuroSCORE-II). Se realizó seguimiento clínico mediante revisión de historias clínicas o contacto telefónico a los 12 meses en todos los pacientes, incluyendo estado vital y realización de intervención valvular (quirúrgica o percutánea). Se consideraron muertes de causa cardíaca las debidas a insuficiencia cardíaca, muerte súbita o infarto de miocardio...
Aortic stenosis (AS) is the most common cardiac valve disease in developed countries and has a poor prognosis when symptoms appear. According to clinical practice guidelines, aortic valve replacement (AVR) is the treatment of choice for symptomatic severe AS. Transcatheter aortic valve (TAVI) implantation has good results in the short and medium term follow-up.Therefore, it plays an important role as a treatment option in patients with symptomatic severe AS. Despite current therapeutic options, many patients with symptomatic severe AS receive medical treatment alone. Our main objective was to evaluate the determinants in the management and prognosis of severe AS in real life. Methods: Multicenter registry (in 48 Spanish centers) that included all adults with severe AS (mean gradient ≥40 mmHg or AVA <1 cm2 estimated by continuity equation, without previous valvular intervention) diagnosed by transthoracic echocardiography during the month of January 2014. The clinical characteristics, echocardiographic data, Charlson's comorbidity index and the European System for Cardiac Operative Risk Evaluation (EuroSCORE-II) were recorded. Clinical follow-up assessing vital status and valvular intervention was performed by means of medical records and phone contact in all patients. The type of valvular intervention (surgical or percutaneous) was also recorded. Deaths due to heart failure, sudden death, or myocardial infarction were considered as cardiac deaths...
Aortic stenosis (AS) is the most common cardiac valve disease in developed countries and has a poor prognosis when symptoms appear. According to clinical practice guidelines, aortic valve replacement (AVR) is the treatment of choice for symptomatic severe AS. Transcatheter aortic valve (TAVI) implantation has good results in the short and medium term follow-up.Therefore, it plays an important role as a treatment option in patients with symptomatic severe AS. Despite current therapeutic options, many patients with symptomatic severe AS receive medical treatment alone. Our main objective was to evaluate the determinants in the management and prognosis of severe AS in real life. Methods: Multicenter registry (in 48 Spanish centers) that included all adults with severe AS (mean gradient ≥40 mmHg or AVA <1 cm2 estimated by continuity equation, without previous valvular intervention) diagnosed by transthoracic echocardiography during the month of January 2014. The clinical characteristics, echocardiographic data, Charlson's comorbidity index and the European System for Cardiac Operative Risk Evaluation (EuroSCORE-II) were recorded. Clinical follow-up assessing vital status and valvular intervention was performed by means of medical records and phone contact in all patients. The type of valvular intervention (surgical or percutaneous) was also recorded. Deaths due to heart failure, sudden death, or myocardial infarction were considered as cardiac deaths...
Description
Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 25/04/2017