Heart failure & cardiomyopathiesCohort study
Prevalence, Characteristics and Prognostic Impact of Aortic Valve Disease in Patients with Heart Failure and Reduced, Mildly Reduced, and Preserved Ejection Fraction: An Analysis of the ESC Heart Failure Long-Term Registry
- Prospective registry cohort study
- multicentre registry
Authors' conclusion
In the ESC HFA EORP HF Long-Term Registry, one in 10 patients with HF had AVD, with AS and MAVD being especially common in HFpEF and AR being similarly distributed across all ejection fraction categories. AS and MAVD, but not AR, were independently associated with increased risk of in-hospital mortality and 12-month composite outcome, regardless of ejection fraction category.
Study context
- Population
- Patients with chronic and acute heart failure (HF) (HFrEF, HFmrEF, HFpEF), ESC HFA EORP HF Long-Term Registry
- Participants
- 15,216 patients
- Exposure
- Moderate to severe aortic valve disease (AVD) vs no AVD in HF
- ASn = 648
- ARn = 706
- MAVDn = 234
- Outcome
- Composite of:
- CV death
- HF hospitalization
- Follow-up
- 12 months
Main finding
As reported in the abstract
CV death or HF hospitalization
Each group vs no AVDAdjusted hazard ratio (95% CI)
AS
1.43(1.23–1.67)
MAVD
1.37(1.07–1.74)
AR
1.13(0.96–1.33)
Observational data: associations, not effects.
Further findings
| Outcome | AS | AR | MAVD | No AVD |
|---|---|---|---|---|
| Prevalence of AVD | 4.3% | 4.6% | 1.5% | |
| HFpEF | 6% | 8% | 3% | Not reported in the abstract |
| HFmrEF | 6% | 3% | 2% | Not reported in the abstract |
| HFrEF | 4% | 3% | 1% | Not reported in the abstract |
AS and composite outcome, by EF category
- Association of AS with composite outcome observed regardless of EF category
Factors associated with AVD
- Strongest associations: age and HFpEF with AS; LV end-diastolic diameter with AR
Original publication
Prevalence, Characteristics and Prognostic Impact of Aortic Valve Disease in Patients with Heart Failure and Reduced, Mildly Reduced, and Preserved Ejection Fraction: An Analysis of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail. Published 6 June 2023. doi:10.1002/ejhf.2908
Summarised from the published abstract; every number is checked against it