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Pearl Toh, 31 Dec 2019
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DBP, heart rate predict mortality in chronic aortic regurgitation

4 days ago

Diastolic blood pressure (DBP) and resting heart rate (RHR) in patients with haemodynamically significant aortic regurgitation (AR) strongly predict all-cause mortality, independent of demographics, comorbidities, guideline-based surgical triggers, presence of hypertension and use of medications, suggests a new study.

“Therefore, DBP and RHR should be integrated into comprehensive clinical decision making for these patients,” the authors said.

From 2006 to 2017, 820 consecutive patients (mean age, 59±17 years; 82 percent men) with moderate-to-severe AR were retrospectively identified and followed for 5.5±3.5 years. Of these, 104 succumbed to death under medical management, and 400 underwent aortic valve surgery (AVS).

Age, symptoms, left ventricular ejection fraction (LVEF), LV end-systolic diameter-index (LVESDi), DBP and RHR were independently associated with all-cause mortality (p-all0.002).

After adjusting for demographics, comorbidities and surgical triggers (ie, symptoms, LVEF and LVESDi), only baseline DBP (adjusted hazard ratio [aHR] per 10-mm Hg increase, 0.79, 95 percent confidence interval [CI], 0.66–0.94; p=0.009) and baseline RHR (adjusted HR per 10 beat per min [bpm] increase, 1.23, 95 percent CI, 1.03–1.45; p=0.01) independently predicted all-cause death.

“These associations persisted after adjustment for presence of hypertension, medications, time-dependent AVS, and using average DBP and RHR (p-all≤0.02),” the authors said.

Furthermore, patients with AR, compared with the general population, demonstrated higher mortality (relative risk of death, >1), which further increased in inverse proportion (p-nonlinearity=0.002) to DBP starting at 70 mm Hg and peaking at 55 mm Hg and in direct proportion to RHR starting at 60 bpm.

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Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
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At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
6 days ago
Testosterone treatment may slightly improve sexual functioning and quality of life in men without underlying organic causes of hypogonadism, but it offers little to no benefit for other common symptoms of ageing, according to a study. In addition, long-term efficacy and safety of this therapy remain unknown.
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