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Response to: Correspondence on ‘Prevalence of pulmonary hypertension in aortic regurgitation and its influence on outcomes’ by Michelena et al
  1. Seshika Ratwatte1,2,
  2. David S Celermajer1,2
  1. 1 Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  2. 2 Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr David S Celermajer, Cardiology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia; David.Celermajer{at}

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The Authors' reply We read the response letter to our paper ‘Prevalence of pulmonary hypertension in aortic regurgitation and its influence in outcomes’1 which raised several interesting points.

In response, it is important to question some of the assumptions in this letter, particularly concerning the assertion that ‘clinically significant AR is a disease largely affecting younger males’. The reference to support this statement introduces a major selection bias; first, this was a single-centre retrospective study from the Mayo Clinic, including only patients undergoing surgery for aortic regurgitation (AR).2 Over 40% had bicuspid aortic valves. This is clearly a very skewed sample. References 4 and 5 of the letter, also about AR epidemiology, …

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  • Contributors SR and DSC contributed to drafting a response to the correspondence letter.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests DSC is on the Editorial Board of BMJ HEART.

  • Provenance and peer review Commissioned; internally peer reviewed.

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