Concomitant Mitral Regurgitation in Severe Aortic Stenosis ― Insights From the CURRENT AS Registry-2 ―
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- Obayashi Yuki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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- Takeji Yasuaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
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- Taniguchi Tomohiko
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
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- Morimoto Takeshi
- Department of Clinical Epidemiology, Hyogo Medical University
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- Shirai Shinichi
- Department of Cardiology, Kokura Memorial Hospital
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- Kitai Takeshi
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center
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- Tabata Hiroyuki
- Department of Cardiology, Kokura Memorial Hospital
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- Ohno Nobuhisa
- Division of Cardiovascular Surgery, Kokura Memorial Hospital
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- Murai Ryosuke
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
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- Osakada Kohei
- Department of Cardiology, Kurashiki Central Hospital
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- Murata Koichiro
- Department of Cardiology, Shizuoka City Shizuoka Hospital
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- Nakai Masanao
- Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital
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- Tsuneyoshi Hiroshi
- Department of Cardiovascular Surgery, Shizuoka General Hospital
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- Tada Tomohisa
- Department of Cardiology, Shizuoka General Hospital
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- Amano Masashi
- Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center
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- Watanabe Shin
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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- Shiomi Hiroki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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- Watanabe Hirotoshi
- Department of Cardiology, Hirakata Kohsai Hospital
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- Yoshikawa Yusuke
- Department of Biostatistics, National Cerebral and Cardiovascular Center
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- Nishikawa Ryusuke
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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- Yamamoto Ko
- Department of Cardiology, Kokura Memorial Hospital
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- Toyofuku Mamoru
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center
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- Tatsushima Shojiro
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center
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- Kanamori Norio
- Division of Cardiology, Shimada General Medical Center
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- Miyake Makoto
- Department of Cardiology, Tenri Hospital
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- Nakayama Hiroyuki
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
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- Nagao Kazuya
- Department of Cardiovascular Center, Osaka Red Cross Hospital
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- Izuhara Masayasu
- Department of Cardiology, Kishiwada City Hospital
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- Nakatsuma Kenji
- Department of Cardiology, Mitsubishi Kyoto Hospital
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- Inoko Moriaki
- Cardiovascular Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital
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- Fujita Takanari
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center
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- Kimura Masahiro
- Department of Cardiology, Koto Memorial Hospital
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- Ishii Mitsuru
- Department of Cardiology, National Hospital Organization Kyoto Medical Center
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- Usami Shunsuke
- Department of Cardiology, Kansai Electric Power Hospital
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- Nakazeki Fumiko
- Department of Cardiology, Japanese Red Cross Otsu Hospital
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- Togi Kiyonori
- Department of Cardiology, Kindai University Nara Hospital
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- Inuzuka Yasutaka
- Department of Cardiology, Shiga General Hospital
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- Ando Kenji
- Department of Cardiology, Kokura Memorial Hospital
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- Komiya Tatsuhiko
- Department of Cardiovascular Surgery, Kurashiki Central Hospital
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- Ono Koh
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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- Minatoya Kenji
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University
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- Kimura Takeshi
- Department of Cardiology, Hirakata Kohsai Hospital
Abstract
<p>Background: Data on concomitant mitral regurgitation (MR) in patients with severe aortic stenosis (AS) are scarce.</p><p>Methods and Results: We investigated the risk of concomitant MR in patients with severe AS in the CURRENT AS Registry-2 according to initial treatment strategy (transcatheter aortic valve implantation [TAVI], surgical aortic valve replacement [SAVR], or conservative). Among 3,365 patients with severe AS, 384 (11.4%) had moderate/severe MR (TAVI: n=126/1,148; SAVR: n=68/591; conservative: n=190/1,626). The cumulative 3-year incidence for death or heart failure (HF) hospitalization was significantly higher in the moderate/severe than no/mild MR group in the entire population (54.6% vs. 34.3%, respectively; P<0.001) and for each treatment strategy (TAVI: 45.0% vs. 31.8% [P=0.006]; SAVR: 31.9% vs. 18.7% [P<0.001]; conservative: 67.8% vs. 41.6% [P<0.001]). The higher adjusted risk of moderate/severe MR relative to no/mild MR for death or HF hospitalization was not significant in the entire population (hazard ratio [HR] 1.15; 95% confidence interval [CI] 0.95–1.39; P=0.15); however, the risk was significant in the SAVR (HR 1.92; 95% CI 1.04–3.56; P=0.04) and conservative (HR 1.30; 95% CI 1.02–1.67; P=0.04) groups, but not in the TAVI group (HR 1.03; 95% CI 0.70–1.52; P=0.86), despite no significant interaction (Pinteraction=0.37).</p><p>Conclusions: Moderate/severe MR was associated with a higher risk for death or HF hospitalization in the initial SAVR and conservative strategies, while the association was less pronounced in the initial TAVI strategy.</p>
Journal
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- Circulation Journal
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Circulation Journal advpub (0), 2024-05-09
The Japanese Circulation Society