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Влияние умеренного несоответствия «пациент–протез» на отдалённые результаты у пациентов с тяжёлым аортальным стенозом с парадоксально сниженными градиентами на фоне сниженного ударного объёма левого желудочка после протезирования аортального клапана
Влияние умеренного несоответствия «пациент–протез» на отдалённые результаты у пациентов с тяжёлым аортальным стенозом с парадоксально сниженными градиентами на фоне сниженного ударного объёма левого желудочка после протезирования аортального клапана
Базылев В.В., Бабуков Р.М., Бартош Ф.Л., Лёвина А.В. Влияние умеренного несоответствия «пациент-протез» на отдалённые результаты у пациентов с тяжёлым аортальным стенозом с парадоксально сниженными градиентами на фоне сниженного ударного объёма левого желудочка после протезирования аортального клапана биологическим протезом: ретроспективное сравнительное исследование // CardioСоматика. 2023. Т. 14, № 3. С. 143–153. DOI: https://doi.org/10.17816/CS340856
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Аннотация
Цель. Оценить влияние умеренного несоответствия «пациент-протез» (НПП) на отдалённые результаты после протезирования аортального клапана у пациентов с тяжёлым аортальным стенозом с парадоксально сниженными градиентами на фоне сниженного ударного объёма левого желудочка.
Материалы и методы. Проанализированы данные 88 пациентов с симптоматическим тяжёлым аортальным стенозом, соответствующим критерию «парадоксально сниженные градиенты на фоне сниженного ударного объёма левого желудочка». Пациенты были разделены на 2 группы: 1-я группа (n=42, средний возраст 67±4 лет) — с парадоксально сниженными градиентами на фоне сниженного ударного объёма левого желудочка, с умеренным НПП; 2-я группа (n=46, средний возраст 68±6 лет) — с парадоксально сниженными градиентами на фоне сниженного ударного объёма левого желудочка, без НПП. Всем пациентам проводили комплексную трансторакальную эхокардиографическую оценку изучаемых параметров.
Результаты. Средний период наблюдения составил 84 мес. За время наблюдения зарегистрировано 35 (40%) летальных исходов. Не было обнаружено значимых различий в госпитальной летальности: 2 (4,7%) и 2 (4,3%) для группы 1 и 2 соответственно (p=0,2). В отдалённом периоде наблюдения отмечена значимая разница в выживаемости и частоте госпитализации по поводу обострения сердечной недостаточности между пациентами с НПП и без него: 46 и 71%, 37 и 72% соответственно (p <0,001). Также в отдалённом периоде наблюдения у пациентов c НПП имели место тенденция к более медленной регрессии массы левого желудочка и объёма левого предсердия, а также более медленное восстановление глобальной продольной деформации левого желудочка и толерантности к физической нагрузке в сравнении с пациентами без НПП. Не установлено значимых различий по частоте развития инсульта (90 и 91%; p=0,7). По результатам анализа модели регрессии Кокса, независимыми предикторами летальных событий и риска госпитализации по поводу обострения сердечной недостаточности выступили индекс ударного объёма левого желудочка и индекс площади эффективного отверстия аортального клапана.
Заключение. Умеренное НПП у пациентов с парадоксально сниженными градиентами на фоне сниженного ударного объёма левого желудочка независимо связано с повышенной смертностью и частотой госпитализации по поводу обострения сердечной недостаточности.
Ключевые слова: аортальный стеноз; несоответствие «пациент–протез»; биологический протез; парадоксально низкий ударный объём; низкие градиенты
MATERIALS AND METHODS: We reviewed data from 88 patients with symptomatic severe aortic stenosis who met the criteria of paradoxically reduced gradients against the background of a reduced stroke volume of the left ventricle. Patients were divided into two groups: Group 1 (n=42, mean age 67±4 years) with paradoxically reduced gradients against the background of reduced stroke volume of the left ventricle, with a moderate patient–prosthesis mismatch, and Group 2 (n=46, mean age 68±6 years) with paradoxically reduced gradients against the background of reduced stroke volume of the left ventricle, with no patient–prosthesis discrepancy. All patients underwent transthoracic echocardiography.
RESULTS: The mean follow-up period was 84 (quarterly interval 75±98) months. During the follow-up period, 35 (40%) deaths were recorded. There were no significant differences in in-hospital mortality: 2 (4.7%) and 2 (4.3%), respectively (p=0.2). There was a significant difference in survival and hospitalization rates for heart failure exacerbation between patients with and without patient–prosthesis mismatch in the long-term follow-up period: 46 and 71% and 37 and 72%, respectively (p <0.001). Patients with patient–prosthesis mismatch had a slower regression of left ventricle mass and left atrial volume and a slower recovery of global longitudinal deformation of the left ventricle and exercise tolerance during the long-term follow-up period compared with patients without patient–prosthesis mismatch. There were no significant differences in the incidence of stroke (90 and 91%, p=0.7). The results of Cox regression showed that the left ventricular stroke volume index and the aortic valve effective orifice area index were independent predictors of lethal events and the risk of hospitalization for heart failure exacerbation.
CONCLUSION: Moderate patient–prosthesis mismatch is associated with increased mortality and hospitalization for heart failure exacerbations in patients with paradoxically reduced gradients and reduced left ventricular stroke volume.
Keywords: aortic stenosis; patient–prosthesis mismatch; biological prosthesis; paradoxically low stroke volume low gradients
Материалы и методы. Проанализированы данные 88 пациентов с симптоматическим тяжёлым аортальным стенозом, соответствующим критерию «парадоксально сниженные градиенты на фоне сниженного ударного объёма левого желудочка». Пациенты были разделены на 2 группы: 1-я группа (n=42, средний возраст 67±4 лет) — с парадоксально сниженными градиентами на фоне сниженного ударного объёма левого желудочка, с умеренным НПП; 2-я группа (n=46, средний возраст 68±6 лет) — с парадоксально сниженными градиентами на фоне сниженного ударного объёма левого желудочка, без НПП. Всем пациентам проводили комплексную трансторакальную эхокардиографическую оценку изучаемых параметров.
Результаты. Средний период наблюдения составил 84 мес. За время наблюдения зарегистрировано 35 (40%) летальных исходов. Не было обнаружено значимых различий в госпитальной летальности: 2 (4,7%) и 2 (4,3%) для группы 1 и 2 соответственно (p=0,2). В отдалённом периоде наблюдения отмечена значимая разница в выживаемости и частоте госпитализации по поводу обострения сердечной недостаточности между пациентами с НПП и без него: 46 и 71%, 37 и 72% соответственно (p <0,001). Также в отдалённом периоде наблюдения у пациентов c НПП имели место тенденция к более медленной регрессии массы левого желудочка и объёма левого предсердия, а также более медленное восстановление глобальной продольной деформации левого желудочка и толерантности к физической нагрузке в сравнении с пациентами без НПП. Не установлено значимых различий по частоте развития инсульта (90 и 91%; p=0,7). По результатам анализа модели регрессии Кокса, независимыми предикторами летальных событий и риска госпитализации по поводу обострения сердечной недостаточности выступили индекс ударного объёма левого желудочка и индекс площади эффективного отверстия аортального клапана.
Заключение. Умеренное НПП у пациентов с парадоксально сниженными градиентами на фоне сниженного ударного объёма левого желудочка независимо связано с повышенной смертностью и частотой госпитализации по поводу обострения сердечной недостаточности.
Ключевые слова: аортальный стеноз; несоответствие «пациент–протез»; биологический протез; парадоксально низкий ударный объём; низкие градиенты
________________________________________________
MATERIALS AND METHODS: We reviewed data from 88 patients with symptomatic severe aortic stenosis who met the criteria of paradoxically reduced gradients against the background of a reduced stroke volume of the left ventricle. Patients were divided into two groups: Group 1 (n=42, mean age 67±4 years) with paradoxically reduced gradients against the background of reduced stroke volume of the left ventricle, with a moderate patient–prosthesis mismatch, and Group 2 (n=46, mean age 68±6 years) with paradoxically reduced gradients against the background of reduced stroke volume of the left ventricle, with no patient–prosthesis discrepancy. All patients underwent transthoracic echocardiography.
RESULTS: The mean follow-up period was 84 (quarterly interval 75±98) months. During the follow-up period, 35 (40%) deaths were recorded. There were no significant differences in in-hospital mortality: 2 (4.7%) and 2 (4.3%), respectively (p=0.2). There was a significant difference in survival and hospitalization rates for heart failure exacerbation between patients with and without patient–prosthesis mismatch in the long-term follow-up period: 46 and 71% and 37 and 72%, respectively (p <0.001). Patients with patient–prosthesis mismatch had a slower regression of left ventricle mass and left atrial volume and a slower recovery of global longitudinal deformation of the left ventricle and exercise tolerance during the long-term follow-up period compared with patients without patient–prosthesis mismatch. There were no significant differences in the incidence of stroke (90 and 91%, p=0.7). The results of Cox regression showed that the left ventricular stroke volume index and the aortic valve effective orifice area index were independent predictors of lethal events and the risk of hospitalization for heart failure exacerbation.
CONCLUSION: Moderate patient–prosthesis mismatch is associated with increased mortality and hospitalization for heart failure exacerbations in patients with paradoxically reduced gradients and reduced left ventricular stroke volume.
Keywords: aortic stenosis; patient–prosthesis mismatch; biological prosthesis; paradoxically low stroke volume low gradients
Полный текст
Список литературы
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2. Adda J, Mielot C, Giorgi R, et al. Low-flow, low-gradient severe aortic stenosis despite normal ejection fraction is associated with severe left ventricular dysfunction as assessed by speckle-tracking echocardiography: a multicenter study. Circ Cardiovasc Imaging. 2012;5(1):27–35. doi: 10.1161/CIRCIMAGING.111.967554
3. Lancellotti P, Magne J, Donal E, et al. Clinical outcome in asymptomatic severe aortic stenosis: insights from the new proposed aortic stenosis grading classification. J Am Coll Cardiol. 2012;59(3):235–243. doi: 10.1016/j.jacc.2011.08.072
4. Herrmann HC, Pibarot P, Hueter I, et al. Predictors of mortality and outcomes of therapy in low-flow severe aortic stenosis: a Placement of Aortic Transcatheter Valves (PARTNER) trial analysis. Circulation. 2013;127(23):2316–2326. doi: 10.1161/CIRCULATIONAHA.112.001290
5. Bazylev VV, Tungusov DS, Babukov RM, et al. Influence of prosthesis–patient mismatch on long-term results in patients after aortic valve replacement with a biological prosthesis: retrospective single center study. CardioSomatics. 2022;13(3):139–147. (In Russ). doi: 10.17816/CS87618
6. Pibarot P, Honos GN, Durand LG, Dumesnil JG. The effect of prosthesis-patient mismatch on aortic bioprosthetic valve hemodynamic performance and patient clinical status. Can J Cardiol. 1996;12(4):379–387.
7. Rao V, Jamieson WR, Ivanov J, et al. Prosthesis-patient mismatch affects survival after aortic valve replacement. Circulation. 2000;102(19 Suppl 3):III5–III9.
doi: 10.1161/01.cir.102.suppl_3.iii-5
8. Sá MP, Jacquemyn X, Van den Eynde J, et al. Impact of Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Replacement: Meta-Analysis of Kaplan-Meier-Derived Individual Patient Data. JACC Cardiovasc Imaging. 2023;16(3):298–310. doi: 10.1016/j.jcmg.2022.07.013
9. Baumgartner H Chair, Hung J Co-Chair, Bermejo J, et al. Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging. 2017;18(3):254–275. doi: 10.1093/ehjci/jew335
10. Lancellotti P, Pibarot P, Chambers J, et al. Recommendations for the imaging assessment of prosthetic heart valves: a report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography, the Inter-American Society of Echocardiography, and the Brazilian Department of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17(6):589–590. doi: 10.1093/ehjci/jew025
11. VARC-3 WRITING COMMITTEE; Généreux P, Piazza N, et al. Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research. Eur Heart J. 2021;42(19):1825–1857. doi: 10.1093/eurheartj/ehaa799
12. Hachicha Z, Dumesnil J, Bogaty P, Pibarot P. Paradoxical low-flow, low-gradient severe aortic stenosis despite preserved ejection fraction is associated with higher afterload and reduced survival. Circulation. 2007;115(22):2856–2864. doi: 10.1161/CIRCULATIONAHA.106.668681
13. Dahl JS, Eleid MF, Pislaru SV, et al. Development of paradoxical low-flow, low-gradient severe aortic stenosis. Heart. 2015;101(13):1015–1023. doi: 10.1136/heartjnl-2014-306838
14. Galian-Gay L, Escalona Silva RA, Teixidó-Turà G, et al. Prognosis of Paradoxical Low-Flow Low-Gradient Aortic Stenosis: A Severe, Non-critical Form, With Surgical Treatment Benefits. Front Cardiovasc Med. 2022;9:852–954. doi: 10.3389/fcvm.2022.852954
15. Dweck MR, Boon NA, Newby DE. Calcific aortic stenosis: a disease of the valve and the myocardium. J Am Coll Cardiol. 2012;60(19):1854–1863. doi: 10.1016/j.jacc.2012.02.093
16. Mohty D, Magne J, Deltreuil M, et al. Outcome and impact of surgery in paradoxical low-flow, low-gradient severe aortic stenosis and preserved left ventricular ejection fraction: a cardiac catheterization study. Circulation. 2013;128(11 Suppl 1):235–242. doi: 10.1161/CIRCULATIONAHA.112.000031
17. Rahimtoola SH. The problem of valve prosthesis-patient mismatch. Circulation. 1978;58(1):20–24. doi: 10.1161/01.cir.58.1.20
18. Mohty D, Boulogne C, Magne J, et al. Prevalence and long-term outcome of aortic prosthesis-patient mismatch in patients with paradoxical low-flow severe aortic stenosis. Circulation. 2014;130(11 Suppl 1):25–31. doi: 10.1161/CIRCULATIONAHA.113.007819
19. Mahjoub H, Mathieu P, Larose É, et al. Determinants of aortic bioprosthetic valve calcification assessed by multidetector CT. Heart. 2015;101(6):472–477.
doi: 10.1136/heartjnl-2014-306445
20. Flameng W, Herregods MC, Vercalsteren M, et al. Prosthesis-patient mismatch predicts structural valve degeneration in bioprosthetic heart valves. Circulation.
2010;121(19):2123–2129. doi: 10.1161/CIRCULATIONAHA.109.901272
21. Freitas-Ferraz AB, Nombela-Franco L, Urena M, et al. Transcatheter aortic valve replacement in patients with paradoxical low-flow, low-gradient aortic stenosis: Incidence and predictors of treatment futility. Int J Cardiol. 2020;316:57–63. doi: 10.1016/j.ijcard.2020.04.036
22. Puri R, Iung B, Cohen DJ, Rodés-Cabau J. TAVI or No TAVI: identifying patients unlikely to benefit from transcatheter aortic valve implantation. Eur Heart J.
2016;37(28):2217–2225. doi: 10.1093/eurheartj/ehv756
23. Maes F, Boulif J, Piérard S, et al. Natural history of paradoxical low-gradient severe aortic stenosis. Circ Cardiovasc Imaging. 2014;7(4):714–722.
doi: 10.1161/CIRCIMAGING.113.001695
24. Parikh R, Goodman AL, Barr T, et al. Outcomes of surgical aortic valve replacement for severe aortic stenosis: Incorporation of left ventricular systolic function and stroke volume index. J Thorac Cardiovasc Surg. 2015;149(6):1558.e1–1566.e1. doi: 10.1016/j.jtcvs.2015.03.008
25. O'Gara PT, Shah PB, Sun YP. Paradoxical Low Flow Aortic Stenosis: More Differences Between Men and Women. J Am Coll Cardiol. 2020;75(16):1910–1912.
doi: 10.1016/j.jacc.2020.03.026
26. Okuno T, Corpataux N, Spano G, et al. True-severe stenosis in paradoxical low-flow low-gradient aortic stenosis: outcomes after transcatheter aortic valve replacement. Eur Heart J Qual Care Clin Outcomes. 2021;7(4):366–377. doi: 10.1093/ehjqcco/qcab010
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3. Lancellotti P., Magne J., Donal E., et al. Clinical outcome in asymptomatic severe aortic stenosis: insights from the new proposed aortic stenosis grading classification // J Am Coll Cardiol. 2012. Vol. 59, N 3. P. 235–243. doi: 10.1016/j.jacc.2011.08.072
4. Herrmann H.C., Pibarot P., Hueter I., et al. Predictors of mortality and outcomes of therapy in low-flow severe aortic stenosis: a Placement of Aortic Transcatheter Valves (PARTNER) trial analysis // Circulation. 2013. Vol. 127, N 23. P. 2316–2326. doi: 10.1161/CIRCULATIONAHA.112.001290
5. Базылев В.В., Тунгусов Д.С., Бабуков Р.М., и др. Влияние несоответствия «протез–пациент» на отдалённые результаты лечения после протезирования аортального клапана биологическим протезом: ретроспективное одноцентровое исследование // CardioСоматика. 2022. Т. 13, № 3. С. 139–147. doi: 10.17816/CS87618
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8. Sá M.P., Jacquemyn X., Van den Eynde J., et al. Impact of Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Replacement: Meta-Analysis of Kaplan-Meier-Derived Individual Patient Data // JACC Cardiovasc Imaging. 2023. Vol. 16, N 3. P. 298–310. doi: 10.1016/j.jcmg.2022.07.013
9. Baumgartner H. Chair, Hung J. Co-Chair, Bermejo J., et al. Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography // Eur Heart J Cardiovasc Imaging. 2017. Vol. 18, N 3. P. 254–275. doi: 10.1093/ehjci/jew335
10. Lancellotti P., Pibarot P., Chambers J., et al. Recommendations for the imaging assessment of prosthetic heart valves: a report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography, the Inter-American Society of Echocardiography, and the Brazilian Department of Cardiovascular Imaging // Eur Heart J Cardiovasc Imaging. 2016. Vol. 17, N 6. P. 589–590. doi: 10.1093/ehjci/jew025
11. VARC-3 WRITING COMMITTEE; Généreux P., Piazza N., et al. Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research // Eur Heart J. 2021. Vol. 42, N 19. P. 1825–1857. doi: 10.1093/eurheartj/ehaa799
12. Hachicha Z., Dumesnil J., Bogaty P., Pibarot P. Paradoxical low-flow, low-gradient severe aortic stenosis despite preserved ejection fraction is associated with higher afterload and reduced survival // Circulation. 2007. Vol. 115, N 22. P. 2856–2864. doi: 10.1161/CIRCULATIONAHA.106.668681
13. Dahl J.S., Eleid M.F., Pislaru S.V., et al. Development of paradoxical low-flow, low-gradient severe aortic stenosis // Heart. 2015. Vol. 101, N 13. P. 1015–1023.
doi: 10.1136/heartjnl-2014-306838
14. Galian-Gay L., Escalona Silva R.A., Teixidó-Turà G., et al. Prognosis of Paradoxical Low-Flow Low-Gradient Aortic Stenosis: A Severe, Non-critical Form, With Surgical Treatment Benefits // Front Cardiovasc Med. 2022. N 9. P. 852–954. doi: 10.3389/fcvm.2022.852954
15. Dweck M.R., Boon N.A., Newby D.E. Calcific aortic stenosis: a disease of the valve and the myocardium // J Am Coll Cardiol. 2012. Vol. 60, N 19. P. 1854–1863.
doi: 10.1016/j.jacc.2012.02.093
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17. Rahimtoola S.H. The problem of valve prosthesis-patient mismatch // Circulation. 1978. Vol. 58, N 1. P. 20–24. doi: 10.1161/01.cir.58.1.20
18. Mohty D., Boulogne C., Magne J., et al. Prevalence and long-term outcome of aortic prosthesis-patient mismatch in patients with paradoxical low-flow severe aortic stenosis // Circulation. 2014. Vol. 130, N 11, Suppl. 1. P. 25–31. doi: 10.1161/CIRCULATIONAHA.113.007819
19. Mahjoub H., Mathieu P., Larose É., et al. Determinants of aortic bioprosthetic valve calcification assessed by multidetector CT // Heart. 2015. Vol. 101, N 6. P. 472–477.
doi: 10.1136/heartjnl-2014-306445
20. Flameng W., Herregods M.C., Vercalsteren M., et al. Prosthesis-patient mismatch predicts structural valve degeneration in bioprosthetic heart valves // Circulation. 2010. Vol. 121,
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P. 2217–2225. doi: 10.1093/eurheartj/ehv756
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doi: 10.1161/CIRCIMAGING.113.001695
24. Parikh R., Goodman A.L., Barr T., et al. Outcomes of surgical aortic valve replacement for severe aortic stenosis: Incorporation of left ventricular systolic function and stroke volume index // J Thorac Cardiovasc Surg. 2015. Vol. 149, N 6. P. 1558.e1–1566.e1. doi: 10.1016/j.jtcvs.2015.03.008
25. O'Gara P.T., Shah P.B., Sun Y.P. Paradoxical Low Flow Aortic Stenosis: More Differences Between Men and Women // J Am Coll Cardiol. 2020. Vol. 75, N 16. P. 1910–1912.
doi: 10.1016/j.jacc.2020.03.026
26. Okuno T., Corpataux N., Spano G., et al. True-severe stenosis in paradoxical low-flow low-gradient aortic stenosis: outcomes after transcatheter aortic valve replacement // Eur Heart J Qual Care Clin Outcomes. 2021. Vol. 7, N 4. P. 366–377. doi: 10.1093/ehjqcco/qcab010
________________________________________________
2. Adda J, Mielot C, Giorgi R, et al. Low-flow, low-gradient severe aortic stenosis despite normal ejection fraction is associated with severe left ventricular dysfunction as assessed by speckle-tracking echocardiography: a multicenter study. Circ Cardiovasc Imaging. 2012;5(1):27–35. doi: 10.1161/CIRCIMAGING.111.967554
3. Lancellotti P, Magne J, Donal E, et al. Clinical outcome in asymptomatic severe aortic stenosis: insights from the new proposed aortic stenosis grading classification. J Am Coll Cardiol. 2012;59(3):235–243. doi: 10.1016/j.jacc.2011.08.072
4. Herrmann HC, Pibarot P, Hueter I, et al. Predictors of mortality and outcomes of therapy in low-flow severe aortic stenosis: a Placement of Aortic Transcatheter Valves (PARTNER) trial analysis. Circulation. 2013;127(23):2316–2326. doi: 10.1161/CIRCULATIONAHA.112.001290
5. Bazylev VV, Tungusov DS, Babukov RM, et al. Influence of prosthesis–patient mismatch on long-term results in patients after aortic valve replacement with a biological prosthesis: retrospective single center study. CardioSomatics. 2022;13(3):139–147. (In Russ). doi: 10.17816/CS87618
6. Pibarot P, Honos GN, Durand LG, Dumesnil JG. The effect of prosthesis-patient mismatch on aortic bioprosthetic valve hemodynamic performance and patient clinical status. Can J Cardiol. 1996;12(4):379–387.
7. Rao V, Jamieson WR, Ivanov J, et al. Prosthesis-patient mismatch affects survival after aortic valve replacement. Circulation. 2000;102(19 Suppl 3):III5–III9.
doi: 10.1161/01.cir.102.suppl_3.iii-5
8. Sá MP, Jacquemyn X, Van den Eynde J, et al. Impact of Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Replacement: Meta-Analysis of Kaplan-Meier-Derived Individual Patient Data. JACC Cardiovasc Imaging. 2023;16(3):298–310. doi: 10.1016/j.jcmg.2022.07.013
9. Baumgartner H Chair, Hung J Co-Chair, Bermejo J, et al. Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging. 2017;18(3):254–275. doi: 10.1093/ehjci/jew335
10. Lancellotti P, Pibarot P, Chambers J, et al. Recommendations for the imaging assessment of prosthetic heart valves: a report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography, the Inter-American Society of Echocardiography, and the Brazilian Department of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17(6):589–590. doi: 10.1093/ehjci/jew025
11. VARC-3 WRITING COMMITTEE; Généreux P, Piazza N, et al. Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research. Eur Heart J. 2021;42(19):1825–1857. doi: 10.1093/eurheartj/ehaa799
12. Hachicha Z, Dumesnil J, Bogaty P, Pibarot P. Paradoxical low-flow, low-gradient severe aortic stenosis despite preserved ejection fraction is associated with higher afterload and reduced survival. Circulation. 2007;115(22):2856–2864. doi: 10.1161/CIRCULATIONAHA.106.668681
13. Dahl JS, Eleid MF, Pislaru SV, et al. Development of paradoxical low-flow, low-gradient severe aortic stenosis. Heart. 2015;101(13):1015–1023. doi: 10.1136/heartjnl-2014-306838
14. Galian-Gay L, Escalona Silva RA, Teixidó-Turà G, et al. Prognosis of Paradoxical Low-Flow Low-Gradient Aortic Stenosis: A Severe, Non-critical Form, With Surgical Treatment Benefits. Front Cardiovasc Med. 2022;9:852–954. doi: 10.3389/fcvm.2022.852954
15. Dweck MR, Boon NA, Newby DE. Calcific aortic stenosis: a disease of the valve and the myocardium. J Am Coll Cardiol. 2012;60(19):1854–1863. doi: 10.1016/j.jacc.2012.02.093
16. Mohty D, Magne J, Deltreuil M, et al. Outcome and impact of surgery in paradoxical low-flow, low-gradient severe aortic stenosis and preserved left ventricular ejection fraction: a cardiac catheterization study. Circulation. 2013;128(11 Suppl 1):235–242. doi: 10.1161/CIRCULATIONAHA.112.000031
17. Rahimtoola SH. The problem of valve prosthesis-patient mismatch. Circulation. 1978;58(1):20–24. doi: 10.1161/01.cir.58.1.20
18. Mohty D, Boulogne C, Magne J, et al. Prevalence and long-term outcome of aortic prosthesis-patient mismatch in patients with paradoxical low-flow severe aortic stenosis. Circulation. 2014;130(11 Suppl 1):25–31. doi: 10.1161/CIRCULATIONAHA.113.007819
19. Mahjoub H, Mathieu P, Larose É, et al. Determinants of aortic bioprosthetic valve calcification assessed by multidetector CT. Heart. 2015;101(6):472–477.
doi: 10.1136/heartjnl-2014-306445
20. Flameng W, Herregods MC, Vercalsteren M, et al. Prosthesis-patient mismatch predicts structural valve degeneration in bioprosthetic heart valves. Circulation.
2010;121(19):2123–2129. doi: 10.1161/CIRCULATIONAHA.109.901272
21. Freitas-Ferraz AB, Nombela-Franco L, Urena M, et al. Transcatheter aortic valve replacement in patients with paradoxical low-flow, low-gradient aortic stenosis: Incidence and predictors of treatment futility. Int J Cardiol. 2020;316:57–63. doi: 10.1016/j.ijcard.2020.04.036
22. Puri R, Iung B, Cohen DJ, Rodés-Cabau J. TAVI or No TAVI: identifying patients unlikely to benefit from transcatheter aortic valve implantation. Eur Heart J.
2016;37(28):2217–2225. doi: 10.1093/eurheartj/ehv756
23. Maes F, Boulif J, Piérard S, et al. Natural history of paradoxical low-gradient severe aortic stenosis. Circ Cardiovasc Imaging. 2014;7(4):714–722.
doi: 10.1161/CIRCIMAGING.113.001695
24. Parikh R, Goodman AL, Barr T, et al. Outcomes of surgical aortic valve replacement for severe aortic stenosis: Incorporation of left ventricular systolic function and stroke volume index. J Thorac Cardiovasc Surg. 2015;149(6):1558.e1–1566.e1. doi: 10.1016/j.jtcvs.2015.03.008
25. O'Gara PT, Shah PB, Sun YP. Paradoxical Low Flow Aortic Stenosis: More Differences Between Men and Women. J Am Coll Cardiol. 2020;75(16):1910–1912.
doi: 10.1016/j.jacc.2020.03.026
26. Okuno T, Corpataux N, Spano G, et al. True-severe stenosis in paradoxical low-flow low-gradient aortic stenosis: outcomes after transcatheter aortic valve replacement. Eur Heart J Qual Care Clin Outcomes. 2021;7(4):366–377. doi: 10.1093/ehjqcco/qcab010
Авторы
В.В. Базылев, Р.М. Бабуков*, Ф.Л. Бартош, А.В. Лёвина
Федеральный центр сердечно-сосудистой хирургии, Пенза, Российская Федерация
*ruslan.babukov@mail.ru
Federal Center of Cardiovascular Surgery, Penza, Russian Federation
*ruslan.babukov@mail.ru
Федеральный центр сердечно-сосудистой хирургии, Пенза, Российская Федерация
*ruslan.babukov@mail.ru
________________________________________________
Federal Center of Cardiovascular Surgery, Penza, Russian Federation
*ruslan.babukov@mail.ru
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