Prior research has not been done on the prognostic significance of left ventricular ejection fraction (LVEF) in patients with bicuspid aortic valve (BAV) disease. For a study, researchers sought to identify how the kind of aortic valve failure affected the prognostic significance of LVEF in BAV patients.
They conducted a retrospective analysis of the information gathered from 2,672 individuals registered in a global database of BAV patients. Patients were divided into 4 groups based on the type of aortic valve dysfunction they had, including isolated aortic stenosis (AS) (n = 749), isolated aortic regurgitation (AR) (n = 554), mixed aortic valve disease (MAVD) (n = 190), and no significant aortic valve dysfunction (n = 1,179; excluded from the analysis). To better understand how LVEF strata affected clinical outcomes, the research population was separated into several groups.
When LVEF was <60% across the board in the cohort as a whole, in the AS and AR groups, and when LVEF was <55% in the MAVD group, the risk of all-cause mortality and the composite endpoint of aortic valve replacement or repair (AVR) and all-cause mortality rose. LVEF strata were shown to be substantially linked with a higher incidence of mortality in multivariable analysis (LVEF 50%-59%: HR: 1.83 [95% CI: 1.09-3.07]; P = 0.022; LVEF 30%-49%: HR: 1.97 [95% CI: 1.13-3.41]; P = 0.016; LVEF <30%: HR: 4.20 [95% CI: 2.01-8.75]; P < 0.001; vs. LVEF 60%-70%, reference group).
When the LVEF is <60% in BAV patients, the risk of unfavorable clinical outcomes rises noticeably. According to the findings, the recommendations suggested LVEF cutoff values for AS, AR, and MAVD should be increased from 50% to 60% and from 55% to 55%, respectively, to signal the need for intervention.
Reference: jacc.org/doi/10.1016/j.jacc.2022.06.032
