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https://doi.org/10.1038/s41598-017-05021-9
Title: | Effects of Aortic Valve Replacement on Severe Aortic Stenosis and Preserved Systolic Function: Systematic Review and Network Meta-analysis /692/4019/592/1540 /692/4019/592/75/591 article | Authors: | Zheng, Q Djohan, A.H Lim, E Ding, Z.P Ling, L.H Shi, L Chan, E.S.-Y Chin, C.W.L |
Keywords: | aged aortic valve aortic valve stenosis coronary artery blood flow female heart stroke volume human male meta analysis middle aged mortality pathophysiology physiology probability prognosis publishing survival analysis systole transcatheter aortic valve implantation very elderly Aged Aged, 80 and over Aortic Valve Aortic Valve Stenosis Coronary Circulation Female Humans Male Middle Aged Probability Prognosis Publication Bias Stroke Volume Survival Analysis Systole Transcatheter Aortic Valve Replacement |
Issue Date: | 2017 | Citation: | Zheng, Q, Djohan, A.H, Lim, E, Ding, Z.P, Ling, L.H, Shi, L, Chan, E.S.-Y, Chin, C.W.L (2017). Effects of Aortic Valve Replacement on Severe Aortic Stenosis and Preserved Systolic Function: Systematic Review and Network Meta-analysis /692/4019/592/1540 /692/4019/592/75/591 article. Scientific Reports 7 (1) : 5092. ScholarBank@NUS Repository. https://doi.org/10.1038/s41598-017-05021-9 | Abstract: | The survival benefits of aortic valve replacement (AVR) in the different flow-gradient states of severe aortic stenosis (AS) is not known. A comprehensive search in PubMed/MEDLINE, Embase, Cochrane Library, CNKI and OpenGrey were conducted to identify studies that investigated the prognosis of severe AS (effective orifice area ?1.0 cm2) and left ventricular ejection fraction ?50%. Severe AS was stratified by mean pressure gradient [threshold of 40 mmHg; high-gradient (HG) and low-gradient (LG)] and stroke volume index [threshold of 35 ml/m2; normal-flow (NL) and low-flow (LF)]. Network meta-analysis was conducted to assess all-cause mortality among each AS sub-type with rate ratio (RR) reported. The effects of AVR on prognosis were examined using network meta-regression. In the pooled analysis (15 studies and 9,737 patients), LF states (both HG and LG) were associated with increased mortality rate (LFLG: RR 1.88; 95% CI: 1.43-2.46; LFHG: RR: 1.77; 95% CI: 1.16-2.70) compared to moderate AS; and NF states in both HG and LG had similar prognosis as moderate AS (NFLG: RR 1.11; 95% CI: 0.81-1.53; NFHG: RR 1.16; 95% CI: 0.82-1.64). AVR conferred different survival benefits: it was most effective in NFHG (RR with AVR /RR without AVR : 0.43; 95% CI: 0.22-0.82) and least in LFLG (RR with AVR /RR without AVR : 1.19; 95% CI: 0.74-1.94). © 2017 The Author(s). | Source Title: | Scientific Reports | URI: | https://scholarbank.nus.edu.sg/handle/10635/175182 | ISSN: | 20452322 | DOI: | 10.1038/s41598-017-05021-9 |
Appears in Collections: | Elements Staff Publications |
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