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PROGNOSTIC VALUE OF DIASTOLIC FUNCTION PARAMETERS IN SIGNIFICANT AORTIC REGURGITATION. THE ROLE OF THE LEFT ATRIAL STRAIN.
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  • Ana Garcia-Martin,
  • María Abellás,
  • Ariana González Gómez,
  • Luis Rincon Diaz,
  • Juan Manuel Monteagudo-Ruiz,
  • Rocio Hinojar-Baydes,
  • Jose Luis Moya Mur,
  • Jose Zamorano,
  • Covadonga Fernandez-Golfin
Ana Garcia-Martin

Corresponding Author:[email protected]

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María Abellás
Hospital Universitario Ramon y Cajal
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Ariana González Gómez
University Hospital Ramón y Cajal
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Luis Rincon Diaz
Hospital Clinico de Salamanca
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Juan Manuel Monteagudo-Ruiz
Hospital Universitario Ramon y Cajal
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Rocio Hinojar-Baydes
Ramon y Cajal University Hospital
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Jose Luis Moya Mur
Hospital Universitario Ramón y Cajal
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Jose Zamorano
Ramon y Cajal University Hospital
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Covadonga Fernandez-Golfin
Ramon y Cajal University Hospital
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Abstract

Aims. The management of patients with asymptomatic significant aortic regurgitation (sAR) is often challenging and appropriate timing of aortic valve surgery remains controversial. Prognostic value of diastolic parameters has been demonstrated in several cardiac diseases. In particular, left atrial (LA) function has been shown to be an important determinant of morbimortality. The purpose of this study was to analyze the prognostic significance of diastolic function in asymptomatic patients with sAR. Methods and results. A total of 126 patients with asymptomatic sAR were included. Conventional echocardiographic systolic and diastolic function parameters were assessed. LA auto-strain analysis was performed in a subgroup of 57 patients. During a mean follow up of 33±19 months, 25 (19,8%) patients reached the combined end-point. Univariate analysis showed that LV volumes, LVEF, E wave, E/e’ ratio, LA volume and LA reservoir strain (LASr) were significant predictors of events. Multivariate model 1 that tested all echocardiographic variables statistically significant in the univariate model showed that LVEDV [HR=1,02;95% CI:1,01-1,03 (p<0,001)] and E/e’ ratio [HR=1,12;95% CI:1,03-1,23 (p=0,01)] were significant predictors of events. In the subgroup of patients with LA auto-strain analyzed, a second multivariate model including the previous significant variables for the first model as well as LASr, showed that LVEDV [HR=1,05;95% CI:1,01-1,08 (p=0,016)] and LASr [HR=0,8;95% CI:0,65-0,98 (p<0,035)] were the most significant predictors of cardiovascular events. Conclusions. In this population of asymptomatic patients with sAR and normal LV systolic function, baseline diastolic parameters were prognostic markers of cardiovascular events; among them, LASr played a strong independent predictor role.
23 Aug 2021Submitted to Echocardiography
23 Aug 2021Submission Checks Completed
23 Aug 2021Assigned to Editor
29 Aug 2021Reviewer(s) Assigned
30 Sep 2021Review(s) Completed, Editorial Evaluation Pending
04 Oct 2021Editorial Decision: Revise Major
14 Nov 20211st Revision Received
15 Nov 2021Submission Checks Completed
15 Nov 2021Assigned to Editor
15 Nov 2021Reviewer(s) Assigned
23 Nov 2021Review(s) Completed, Editorial Evaluation Pending
24 Nov 2021Editorial Decision: Revise Major
19 Dec 20212nd Revision Received
20 Dec 2021Submission Checks Completed
20 Dec 2021Assigned to Editor
20 Dec 2021Reviewer(s) Assigned
24 Dec 2021Review(s) Completed, Editorial Evaluation Pending
04 Jan 2022Editorial Decision: Revise Major
12 Oct 2021Published in European Heart Journal volume 42 issue Supplement_1. 10.1093/eurheartj/ehab724.1593