Association Between Chronic Obstructive Pulmonary Disease and All-Cause Mortality After Aortic Valve Replacement for Aortic Stenosis

The American Journal of Cardiology, vol. 190, pp. 41–47

Abstract

Chronic obstructive pulmonary disease (COPD) and aortic stenosis (AS) are the most common diseases in which age plays a major role in the increase of their prevalence and when they co-exist, the outcomes prognosis worsens significantly. The aim of the present study was to evaluate the association between pulmonary functional parameters and all-cause mortality after aortic valve replacement (transcatheter or surgical). A total of 400 patients with severe AS and preoperative pulmonary functional test were retrospectively analyzed. Echocardiography and pulmonary functional parameters before aortic valve replacement were collected. COPD severity was defined according to criteria from the Society of Thoracic Surgeons. COPD was present in 128 patients (32%) with severe AS. Patients without COPD had smaller left ventricular (LV) mass and LV end-systolic volume and better LV function than the group with COPD. During a median follow-up of 32 months, 92 patients (23%) died. The survival rates were significantly lower in patients with moderate and severe COPD (log-rank p = 0.003). In the multivariable Cox regression analysis, any grade of COPD was associated with an approximately 2-fold increased risk of all-cause mortality (hazard ratio 1.933; 95% confidence interval 1.166 to 3.204; p = 0.011 for mild COPD and hazard ratio 2.028; 95% confidence interval 1.154 to 3.564; p = 0.014 for moderate or severe COPD). In addition to other clinical factors, any grade of COPD was associated with 2-fold increased risk of all-cause mortality.

Authors 9

1. Rinchyenkhand Myagmardorj
   Affiliation as printed

   Department of Cardiology

2. Takeru Nabeta
   Affiliation as printed

   Department of Cardiology

3. Kensuke Hirasawa
   Affiliation as printed

   Department of Cardiology

4. Gurpreet K. Singh
   Affiliation as printed

   Department of Cardiology

5. Frank van der Kley
   Affiliation as printed

   Department of Cardiology

6. Arend de Weger Aachen Department of Cardio-Thoracic Surgery Heart Lung Centre

   Leiden University Medical Center

   Affiliation as printed

   Department of Cardio-Thoracic Surgery, Heart Lung Center, Leiden University Medical Center, Leiden, The Netherlands

7. Nina Ajmone Marsan
   Affiliation as printed

   Department of Cardiology

8. Jeroen Joost Bax corresponding Aachen Department of Cardiology

   Leiden University Medical Center

   Affiliation as printed

   Department of Cardiology. Electronic address: J.J.Bax@lumc.nl

   Department of Cardiology

9. Victoria Delgado

   Hospital Universitari Germans Trias i Pujol

   Affiliation as printed

   Department of Cardiology; Department of Cardiovascular Imaging, University Hospital Germans Trias i Pujol, Barcelona, Spain

   Department of Cardiology

   Department of Cardiovascular Imaging, University Hospital Germans Trias i Pujol, Barcelona, Spain