RT Journal Article
SR Electronic
T1 Aortic valve prosthesis–patient mismatch and exercise capacity in adult patients with congenital heart disease
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 107
OP 113
DO 10.1136/heartjnl-2015-308013
VO 102
IS 2
A1 Ymkje J van Slooten
A1 Joost P van Melle
A1 Hendrik G Freling
A1 Berto J Bouma
A1 Arie PJ van Dijk
A1 Monique RM Jongbloed
A1 Martijn C Post
A1 Gertjan T Sieswerda
A1 Anna Huis in ‘t Veld
A1 Tjark Ebels
A1 Adriaan A Voors
A1 Petronella G Pieper
YR 2016
UL http://heart.bmj.com/content/102/2/107.abstract
AB Objectives To report the prevalence of aortic valve prosthesis–patient mismatch (PPM) in an adult population with congenital heart disease (CHD) and its impact on exercise capacity. Adults with congenital heart disease (ACHD) with a history of aortic valve replacement may outgrow their prosthesis later in life. However, the prevalence and clinical consequences of aortic PPM in ACHD are presently unknown.Methods From the national Dutch Congenital Corvitia (CONCOR) registry, we identified 207 ACHD with an aortic valve prosthesis for this cross-sectional cohort study. Severe PPM was defined as an indexed effective orifice area ≤0.65 cm2/m2 and moderate PPM as an indexed orifice area ≤0.85 cm2/m2 measured using echocardiography. Exercise capacity was reported as percentage of predicted exercise capacity (PPEC).Results Of the 207 patients, 68% was male, 71% had a mechanical prosthesis and mean age at inclusion was 43.9 years ±11.4. The prevalence of PPM was 42%, comprising 23% severe PPM and 19% moderate PPM. Prevalence of PPM was higher in patients with mechanical prostheses (p<0.001). PPM was associated with poorer exercise capacity (mean PPEC 84% vs 92%; p=0.048, mean difference =−8.3%, p=0.047). Mean follow-up was 2.6±1.1 years during which New York Heart Association (NYHA) class remained stable in most patients. PPM showed no significant effect on death or hospitalisation during follow-up (p=0.218).Conclusions In this study we report a high prevalence (42%) of PPM in ACHD with an aortic valve prosthesis and an independent association of PPM with diminished exercise capacity.