Characteristics, management, and outcomes of patients with multiple native valvular heart disease: a substudy of the...

Area of Science:

• Cardiology
• Valvular Heart Disease Research
• Clinical Epidemiology

Background:

• Valvular heart disease (VHD) management and outcomes are well-studied, but data on multiple native VHD are less comprehensive.
• Understanding the characteristics and prognosis of patients with multiple VHD is crucial for optimizing treatment strategies.

Purpose of the Study:

• To assess the clinical characteristics, management patterns, and survival rates of patients diagnosed with multiple native valvular heart disease (VHD).
• To compare outcomes between patients with single VHD and those with multiple VHD.

Main Methods:

• Analysis of data from the EURObservational VHD II Survey, including 5087 patients with at least one severe left-sided native VHD.
• Patients were categorized into single VHD (Group A), single severe left-sided VHD with moderate ipsilateral VHD (Group B), and multiple severe VHD (Group C).
• Comparison of demographics, comorbidities, cardiac parameters, intervention rates, and 6-month survival across the groups.

Main Results:

• Multiple VHD (Groups B and C) was present in nearly 30% of patients and was associated with higher rates of female sex, congestive heart failure (CHF), and comorbidity.
• Patients with multiple VHD exhibited greater cardiac damage, including higher left atrial volumes and pulmonary pressures, and lower ejection fraction.
• Six-month survival was significantly lower for patients with multiple VHD compared to single VHD, even after adjusting for confounding factors. Groups B and C also had more CHF at 6 months.

Conclusions:

• Multiple native VHD is a common clinical entity associated with increased cardiac damage, higher mortality, and more frequent heart failure at 6 months compared to single VHD.
• Despite the increased severity, patients with multiple VHD underwent valvular intervention at lower rates than those with single VHD.
• Age, CHF, and comorbidity were identified as significant factors associated with mortality in patients with multiple VHD.