Evidence map›Paper›PMID 35213562›Full record

Observational studyPloS one2022

Evaluation of left ventricular diastolic function in patients operated for aortic stenosis.

Henrik Hultkvist, Eva Nylander, Éva Tamás, Rolf Svedjeholm, Jan Engvall, Jonas Holm, Eva Maret, Farkas Vánky

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Henrik HultkvistDepartment of Cardiothoracic and Vascular Surgery, Heart Centre, Linköping University Hospital, Linköping, Sweden.ORCID 0000-0002-8771-0042
Eva NylanderDepartment of Clinical Physiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Éva TamásDepartment of Cardiothoracic and Vascular Surgery, Heart Centre, Linköping University Hospital, Linköping, Sweden.
Rolf SvedjeholmDepartment of Cardiothoracic and Vascular Surgery, Heart Centre, Linköping University Hospital, Linköping, Sweden.
Jan EngvallDepartment of Clinical Physiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.ORCID 0000-0002-5716-5098
Jonas HolmDepartment of Cardiothoracic and Vascular Surgery, Heart Centre, Linköping University Hospital, Linköping, Sweden.
Eva MaretDepartment of Clinical Physiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
Farkas VánkyDepartment of Cardiothoracic and Vascular Surgery, Heart Centre, Linköping University Hospital, Linköping, Sweden.ORCID 0000-0003-1005-091X
Linköping University Hospital · SELinköping University · SEKarolinska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLeft ventricular diastolic dysfunction is common in patients with aortic valve stenosis (AS) and reportedly affects prognosis after surgical aortic valve replacement (SAVR). Here we investigated whether and how diastolic function (assessed following the most recent guidelines) was affected by SAVR, and whether preoperative diastolic function affected postoperative outcome. We also examined whether long-term mortality was associated with preoperative NT-proBNP and postoperative heart failure (PHF).

methodsWe performed a prospective observational study of 273 patients with AS who underwent AVR with or without concomitant coronary artery bypass surgery. Of these patients, 247 were eligible for assessment of left ventricular (LV) filling pressure. Preoperatively and at the 6-month postoperative follow-up, we measured N-terminal pro-B type natriuretic peptide (NT-proBNP) in serum and assessed diastolic function with Doppler echocardiography. PHF was diagnosed using prespecified criteria. Multivariable logistic regression was performed to explore variables associated with high LV filling pressure. Cox regression was performed to explore variables associated with mortality, accounting for timeto-event.

resultsAt the time of surgery, 22% (n = 54) of patients had diastolic dysfunction expressed as high LV filling pressure. Of these 54 patients, 27 (50%) showed postoperative diastolic function improvement. Among the 193 patients with preoperative low LV filling pressure, 24 (12%) showed postoperative diastolic function deterioration. Increased long-term mortality was associated with PHF and high preoperative NT-proBNP, but not with preoperative or postoperative diastolic dysfunction. Cox regression revealed the following independent risk factors for long-term mortality: diabetes, renal dysfunction, preoperative NT-proBNP>960 ng/L, age, and male gender.

conclusionsSurgery for aortic stenosis improved diastolic function in patients with high LV filling pressure in 50% of the patients. Our results could not confirm the previously suggested role of diastolic dysfunction as a marker for poor long-term survival after SAVR. Our findings showed that both PHF and high preoperative NT-proBNP were associated with long-term mortality.

Indexed as

Aortic ValveAortic Valve StenosisEchocardiography, DopplerHeart Valve Prosthesis ImplantationAgedAged, 80 and overFemaleHumansLongitudinal StudiesMaleNatriuretic Peptide, BrainPeptide FragmentsProspective StudiesVentricular Function, LeftNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)

Identifiers

PMID35213562
PMCPMC8880429
OpenAlexW4214640849

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.