Major non-cardiac surgery is a risk factor for rapid hemodynamic progression of non-rheumatic aortic stenosis.
BACKGROUND
Inflammatory processes are suggested to play a pathogenic role in the development and progression of non-rheumatic aortic stenosis (AS). Major surgery causes an inflammatory reaction. With the increasing prevalence of non-rheumatic AS, the number of affected patients undergoing major surgery increases. We hypothesized that major non-cardiac surgery (MNCS) could accelerate the progression of non-rheumatic AS.


RESULTS
We enrolled 218 consecutive patients with non-rheumatic AS who underwent transthoracic echocardiography (TTE) at least twice more than 6 months apart. Study patients were divided into the MNCS group and the non-MNCS group. The MNCS group consisted of patients who underwent MNCS during the TTE follow-up interval. At baseline, peak pressure gradient across the aortic valve (AVG) was similar between the groups. Also baseline clinical characteristics and TTE follow-up interval were similar. The annual rate of peak AVG increase was much higher in the MNCS group than in the non-MNCS group. The proportion of patients with rapid hemodynamic progression was much higher in the MNCS group than in the non-MNCS group. Multiple logistic regression analysis showed that MNCS was an independent predictor of rapid hemodynamic progression of non-rheumatic AS.


CONCLUSIONS
The present study indicates for the first time that MNCS is associated with the rapid progression of non-rheumatic AS.
Central Clinical Laboratory, Nara Medical University.
Reiko
R
Mizuno
Shin-taro
ST
Yamagami
Tsukimi
T
Higashi
Yasuki
Y
Nakada
Yukiji
Y
Takeda
Satoshi
S
Okayama
Shinichi
S
Fujimoto
Yoshihiko
Y
Saito
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology*; D012189:Retrospective Studies