{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T18:35:56Z","timestamp":1768070156798,"version":"3.49.0"},"reference-count":25,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,3,8]]},"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the role of pulmonary artery pressure (PAP) in predicting in-hospital death after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Guangdong General Hospital, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>1639middle-aged and aged patients (mean age 57\u00b16 years) diagnosed with rheumatic mitral disease, undergoing valve replacement surgery and receiving coronary angiography and transthoracic echocardiography before operation, were enrolled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>All participants underwent valve replacement surgery and received coronary angiography before operation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>In-hospital death and 1-year mortality after operation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Included patients were divided into four groups based on the preoperative PAP obtained by echocardiography: group A (PAP\u226430\u2009mm Hg); group B (&gt;30 mm Hg&lt;PAP\u226450\u2009mm Hg), group C (&gt;50 mm Hg&lt;PAP\u226470\u2009mm Hg) and group D (PAP&gt;70\u2009mm Hg). The relationship between PAP and in-hospital death and cumulative rate of 1-year mortality was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In-hospital mortality rate increased gradually but significantly as the PAP level increased, with 1.9% in group A (n=268), 2.3% in group B (n=771), 4.7% in group C (n=384) and 10.2% in group D (n=216) (p&lt;0.001). Multivariate analysis showed that PAP&gt;70\u2009mm Hg was an independent predictor of in-hospital death (OR=2.93, 95%\u2009CI 1.61 to 5.32, p&lt;0.001). PAP&gt;52.5\u2009mm Hg had a sensitivity of 60.3% and specificity of 67.7% in predicting in-hospital death (area under the curve=0.672, 95%\u2009CI 0.602 to 0.743, p&lt;0.001). Kaplan\u2013Meier analysis showed that patients with PAP&gt;52.5\u2009mm Hg had higher 1-year mortality after operation than those without (log-rank=21.51, p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PAP could serve as a predictor of postoperative in-hospital and 1-year mortality after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-014316","type":"journal-article","created":{"date-parts":[[2017,5,11]],"date-time":"2017-05-11T20:10:19Z","timestamp":1494533419000},"page":"e014316","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Value of pulmonary artery pressure in predicting in-hospital and one-year mortality after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease: an observational study"],"prefix":"10.1136","volume":"7","author":[{"given":"Lei","family":"Jiang","sequence":"first","affiliation":[{"name":"Southern Medical University, Guangzhou, China"},{"name":"Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue-biao","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng-cheng","family":"He","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Du","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Developmental Biology, Harvard School of Dental Medicine, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan-hui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial 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