Please use this identifier to cite or link to this item: 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
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