Heart failure & cardiomyopathies

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 FailPublished Prospective registry cohort study

An erratum to this article was published (Eur J Heart Fail, Jan 2024 ↗)

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
Methodological detailsmulticentre registry
  • Multicentre registry

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

OutcomeASARMAVD
Prevalence of AVD4.3%4.6%1.5%
HFpEF6%8%3%
HFmrEF6%3%2%
HFrEF4%3%1%

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

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