title: Impact of mild patient prosthesis mismatch on quality of life in patients with preserved ejection fraction after isolated aortic valve replacement for aortic stenosis.
abstract: OBJECTIVE
  To analyze whether PPM affects QOL and functional status in patients after isolated AVR for aortic stenosis (AS) with preserved left ventricular ejection fraction (LVEF).
  
  
  METHODS
  Consecutive patients who underwent AVR in University Hospital Center Zagreb for isolated severe symptomatic AS and preserved EF were enrolled. Echo data was obtained from complete transthoracic examinations prior and after surgery by offline analysis. Patients were divided into two groups according to the presence of PPM (effective orifice area (EOA)/body surface area (BSA)<0,85cm2/m2). QOL was assessed by telephone interview using Short Form 36-Item Health Survey (SF-36) along with functional NYHA status estimation.
  
  
  RESULTS
  A total of 45 pts were included (23 female), and divided in PPM (n=26), and non-PPM group (n=19). Both groups were similar in pts age, LVEF, AVA/BSA prior surgery. After surgery, 57% of pts had PPM categorized as mild PPM. During follow-up of 2,5years, 3 pts had died and 10 were lost from following. There was no difference in NYHA status after surgery between groups (p=0,758). SF36 results showed no difference between groups. However, there was a significant improvement in Physical functioning (47,50% vs 75,47%,p=0,000) and Role limitation due to physical health (41,41% vs 81,25%, p=0,007) scores in the whole study population after AVR. Males had significantly better Energy/fatigue (p=0,034), Social functioning (p=0,004) and Pain (p=0,017) scores.
  
  
  CONCLUSIONS
  Mild to moderate PPM showed no clinical relevance. All patients revealed improvement in QOL after AVR, while male sex was related to better functioning scores irrespectively of PPM.
authors.affiliation: University Hospital Centre Zagreb, Department of Cardiovascular Diseases, Zagreb, Croatia. Electronic address: vlatka.reskovic@gmail.com.
authors.forename: Vlatka
authors.initials: V
authors.lastname: Reskovic Luksic
authors.affiliation: University Hospital Centre Zagreb, Department of Cardiovascular Diseases, Zagreb, Croatia.
authors.forename: D
authors.initials: D
authors.lastname: Dosen
authors.affiliation: University Hospital Centre Zagreb, Department of Cardiovascular Diseases, Zagreb, Croatia.
authors.forename: M
authors.initials: M
authors.lastname: Pasalic
authors.affiliation: University Hospital Centre Zagreb, Department of Cardiovascular Diseases, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: Jadranka
authors.initials: J
authors.lastname: Separovic Hanzevacki
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013318:Stroke Volume / Q000502:physiology*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Aortic stenosis; Aortic valve replacement; Patient prosthesis mismatch; Quality of life