Podpalov V.V.*, Sevrukevich V.I.*, Deev A.D., Ostrovsky Y.P.*
A method of the 5-year survival prognosing in patients with severe aortic stenosis
*Scientific and Practical center of Cardiology, Belarus
**Federal State Institution "National Research Center for Preventive Medicine" of the Ministry of Healthcare of the Russian Federation, Russian Federation
Abstract.
Objectives. To work out a method of the five-year survival prognosing in patients with severe aortic stenosis (AS), complicated by atrioventricular valves insufficiency.
Material and methods. The prospective study was conducted. Among all patients admitted to the Centre during 2005-2007 there were 198 patients with severe AS and secondary mitral and tricuspid regurgitation. They were divided into 2 groups: the 1st group included 46 patients not operated for different reasons; the 2nd group consisted of 152 patients who had undergone aortic valve replacement in combination with atrioventricular valvuloplasty. The follow-up period lasted for 5 years.
Results. The average age of 198 patients was 59,16 years, the proportion of men - 67%. Postoperative lethality made up 0,7%. During 5 years there were 35 deaths (76,1%) in the 1st group of patients, and 28 persons (18,4%) died in the 2nd group. Out of estimated parameters those with the most significant value in the prognosis of the five-year survival were included in the final prognostic regression model: left ventricular myocardial mass (p=0,086), pulmonary artery systolic pressure (p=0,002), LVEF (p=0,018), aortic valve peak systolic pressure gradient (p=0,038), age (p=0,012), sex (p=0,189) and adjustment coefficients for the fact of operation records were also added (df=10; a2 Wald=103,7; р=0,0001). The model had sensitivity of 87,2% and specificity of 52%. The values of risk factors profiles (RFP) were grouped in deciles. Each decile got respective value of the five-year survival rate which decreased with the growth of RFP.
Conclusions. With the obtained prognostic model the five-year survival can be determined in patients with severe AS complicated by atrioventricular valves insufficiency by means of RFP calculating.
Key words: aortic stenosis, aortic valve replacement, prognostic model.
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