Related Experiment Videos

Predictors of cerebrovascular events and death among patients with valvular heart disease: A population-based study

G W Petty1, B K Khandheria, J P Whisnant

  • 1Division of Cerebrovascular Diseases, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.

Stroke
|November 4, 2000
PubMed

Insights

Patients with valvular heart disease face high risks of cerebrovascular events and death. Age, atrial fibrillation, and severe aortic stenosis predict these events, while age, sex, and comorbidities predict mortality.

Area of Science:

  • Cardiology
  • Neurology
  • Epidemiology

Background:

  • Valvular heart disease (VHD) affects millions globally.
  • Population-based data on cerebrovascular events (CVEs) and survival in VHD patients are limited.
  • Understanding risk factors is crucial for patient management.

Purpose of the Study:

  • To determine the rates and predictors of CVEs and death in a population-based cohort of VHD patients.
  • To provide essential epidemiological insights into VHD outcomes.

Main Methods:

  • Population-based historical cohort study.
  • Inclusion of residents with new diagnoses of mitral stenosis, mitral regurgitation, aortic stenosis, or aortic regurgitation (1985-1992).
  • Kaplan-Meier and Cox proportional hazards models used for analysis.

Main Results:

  • Elevated rates of CVEs (Standardized Morbidity Ratio [SMR] = 3.2) and death (SMR = 2.5) observed in VHD patients.
  • Independent predictors of CVEs: age, atrial fibrillation, and severe aortic stenosis (Risk Ratio [RR] = 3.5).
  • Independent predictors of death: age, sex, CVEs, ischemic heart disease, and congestive heart failure (CHF). Highest risk with both CHF and CVEs (RR = 8.8).

Conclusions:

  • VHD patients have a significantly elevated risk of CVEs and mortality.
  • Key predictors for CVEs include age, atrial fibrillation, and severe aortic stenosis.
  • Age, sex, prior CVEs, CHF, and ischemic heart disease are critical predictors of death in this population.
Abstract

Related Concept Videos

Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...
Regulation of Stroke Volume01:27

Regulation of Stroke Volume

The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Factors affecting Blood pressure01:28

Factors affecting Blood pressure

Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Assessment of the Cardiovascular System I: Subjective Data01:23

Assessment of the Cardiovascular System I: Subjective Data

A thorough health history and physical assessment are essential for identifying cardiovascular disease (CVD) symptoms and distinguishing them from other health issues.
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...