title: Transthoracic Echocardiography Provides Important Long-Term Prognostic Information in Selected Patients Undergoing Endovascular Abdominal Aortic Repair.
abstract: BACKGROUND
  The value of performing transthoracic echocardiography (TTE) as part of the clinical assessment of patients awaiting endovascular repair of the abdominal aorta is little evaluated. We aimed to estimate the prognostic importance of information derived from TTE on long-term all-cause mortality in a selected group of patients undergoing endovascular aneurysm repair.
  
  
  RESULTS
  This was a retrospective cohort study of 273 consecutive patients selected for endovascular aneurysm repair. All patients included in the analysis underwent TTE before their procedure. Multivariable Cox regression analysis was used to estimate the effect of TTE measures on all-cause mortality. Over a mean follow-up of 3.2±1.5 years, there were 78 deaths with a mean time to death of 1.28±1.16 years. A greater tubular ascending aorta (hazard ratio [HR] 5.6, 95% confidence interval [CI] 2.77-11.33), presence of mitral regurgitation (HR 8.13, 95% CI 4.09-12.16), lower left ventricular ejection fraction (HR 0.96, 95% CI 0.93-0.98), younger age (HR 0.97, 95% CI 0.95-0.99), and presence of diabetes mellitus (HR 1.46, 95% CI 1.24-1.89) were predictors of all-cause mortality.
  
  
  CONCLUSIONS
  Echocardiography provides important long-term prognostic information in patients undergoing endovascular aneurysm repair. These TTE indices were more important at predicting outcome than standard conventional risk factors in this patient group. A greater tubular ascending aorta, presence of mitral regurgitation, reduced left ventricular ejection fraction, younger age, and diabetes mellitus were independently associated with long-term mortality.
authors: From the Department of Cardiology, St George's Healthcare NHS Trust, London, United Kingdom (J.M.O., A.G., S.D.F., R.S.); School of Human and Life Sciences, Canterbury Christ Church University, Kent, United Kingdom (J.M.O.); and Department of Outcomes Research, St George's Vascular Institute, St George's University of London, Cranmer Terrace, London, United Kingdom (S.S.B., M.M.T., A.K., P.J.E.H.).
authors: Jamie M
authors: JM
authors: O'Driscoll
authors: From the Department of Cardiology, St George's Healthcare NHS Trust, London, United Kingdom (J.M.O., A.G., S.D.F., R.S.); School of Human and Life Sciences, Canterbury Christ Church University, Kent, United Kingdom (J.M.O.); and Department of Outcomes Research, St George's Vascular Institute, St George's University of London, Cranmer Terrace, London, United Kingdom (S.S.B., M.M.T., A.K., P.J.E.H.).
authors: Sandeep S
authors: SS
authors: Bahia
authors: From the Department of Cardiology, St George's Healthcare NHS Trust, London, United Kingdom (J.M.O., A.G., S.D.F., R.S.); School of Human and Life Sciences, Canterbury Christ Church University, Kent, United Kingdom (J.M.O.); and Department of Outcomes Research, St George's Vascular Institute, St George's University of London, Cranmer Terrace, London, United Kingdom (S.S.B., M.M.T., A.K., P.J.E.H.).
authors: Angela
authors: A
authors: Gravina
authors: From the Department of Cardiology, St George's Healthcare NHS Trust, London, United Kingdom (J.M.O., A.G., S.D.F., R.S.); School of Human and Life Sciences, Canterbury Christ Church University, Kent, United Kingdom (J.M.O.); and Department of Outcomes Research, St George's Vascular Institute, St George's University of London, Cranmer Terrace, London, United Kingdom (S.S.B., M.M.T., A.K., P.J.E.H.).
authors: Sara
authors: S
authors: Di Fino
authors: From the Department of Cardiology, St George's Healthcare NHS Trust, London, United Kingdom (J.M.O., A.G., S.D.F., R.S.); School of Human and Life Sciences, Canterbury Christ Church University, Kent, United Kingdom (J.M.O.); and Department of Outcomes Research, St George's Vascular Institute, St George's University of London, Cranmer Terrace, London, United Kingdom (S.S.B., M.M.T., A.K., P.J.E.H.).
authors: Matthew M
authors: MM
authors: Thompson
authors: From the Department of Cardiology, St George's Healthcare NHS Trust, London, United Kingdom (J.M.O., A.G., S.D.F., R.S.); School of Human and Life Sciences, Canterbury Christ Church University, Kent, United Kingdom (J.M.O.); and Department of Outcomes Research, St George's Vascular Institute, St George's University of London, Cranmer Terrace, London, United Kingdom (S.S.B., M.M.T., A.K., P.J.E.H.).
authors: Alan
authors: A
authors: Karthikesalingam
authors: From the Department of Cardiology, St George's Healthcare NHS Trust, London, United Kingdom (J.M.O., A.G., S.D.F., R.S.); School of Human and Life Sciences, Canterbury Christ Church University, Kent, United Kingdom (J.M.O.); and Department of Outcomes Research, St George's Vascular Institute, St George's University of London, Cranmer Terrace, London, United Kingdom (S.S.B., M.M.T., A.K., P.J.E.H.).
authors: Peter J E
authors: PJ
authors: Holt
authors: From the Department of Cardiology, St George's Healthcare NHS Trust, London, United Kingdom (J.M.O., A.G., S.D.F., R.S.); School of Human and Life Sciences, Canterbury Christ Church University, Kent, United Kingdom (J.M.O.); and Department of Outcomes Research, St George's Vascular Institute, St George's University of London, Cranmer Terrace, London, United Kingdom (S.S.B., M.M.T., A.K., P.J.E.H.). rajan.sharma@stgeorges.nhs.uk.
authors: Rajan
authors: R
authors: Sharma
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D003430:Cross-Sectional Studies; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
keywords: abdominal aortic aneurysm; aneurysm; diabetes mellitus; endovascular repair; transthoracic echocardiography