{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T15:48:26Z","timestamp":1762098506632,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2015,6,2]]},"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Valvuloarterial impedance (Zva) was introduced as a prognostic measure in patients with aortic stenosis (AS). However, it is unclear whether Zva has a prognostic impact on survival after surgical aortic valve replacement (AVR) in patients with severe AS with preserved ejection fraction (EF).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively reviewed 929 consecutive patients who had AVR. We investigated 170 elderly patients (age &gt;65\u2005years, mean 76\u2005years) who had AVR secondary to severe AS (mean gradient \u226540\u2005mm\u2005Hg; aortic valve area \u22641\u2005cm<jats:sup>2<\/jats:sup>; peak velocity \u22654\u2005m\/s). Patients with EF &lt;50%, greater than moderate aortic regurgitation, prior heart surgery and concomitant mitral or tricuspid valve surgery were excluded. Zva was calculated and the patients were divided into two groups; low Zva, Zva &lt;4.3 (n=82) and high Zva, Zva \u22654.3 (n=88). The end point was all-cause of death. Survival curves were calculated according to Kaplan-Meier method.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Age, prevalence of hypertension, diabetes, chronic kidney disease (CKD), atrial fibrillation, symptoms, EF, E\/e\u2032 and concomitant coronary artery bypass graft were not different between the groups. Survival was not different between the groups at 5\u2005years (70% in low Zva and 81% in high Zva; p=0.21) and for the entire follow-up period (p=0.23). Only age was a significant factor in predicting survival by multivariate analyses in Cox proportional hazards model after adjusting for Zva, CKD, atrial fibrillation and hypertension.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our results suggest that preoperative Zva does not have a prognostic impact on postoperative survival in elderly patients with severe AS with preserved EF. Further investigation is needed to elucidate the controversial results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2015-000241","type":"journal-article","created":{"date-parts":[[2015,6,27]],"date-time":"2015-06-27T07:53:57Z","timestamp":1435391637000},"page":"e000241","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Does valvuloarterial impedance impact prognosis after surgery for severe aortic stenosis in the elderly?"],"prefix":"10.1136","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7174-2736","authenticated-orcid":false,"given":"Minako","family":"Katayama","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Q","family":"Najib","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Punnaiah C","family":"Marella","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M'hamed H","family":"Temkit","sequence":"additional","affiliation":[{"name":"Division of Health Sciences Research, Mayo Clinic, Scottsdale, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Belohlavek","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hari P","family":"Chaliki","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,6,26]]},"reference":[{"key":"2025081612222465000_2.1.e000241.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-668X(03)00201-X"},{"key":"2025081612222465000_2.1.e000241.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.10.081"},{"key":"2025081612222465000_2.1.e000241.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.668681"},{"key":"2025081612222465000_2.1.e000241.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.04.079"},{"key":"2025081612222465000_2.1.e000241.5","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2009.190942"},{"key":"2025081612222465000_2.1.e000241.6","doi-asserted-by":"publisher","DOI":"10.1186\/1476-7120-10-43"},{"key":"2025081612222465000_2.1.e000241.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2013.04.003"},{"key":"2025081612222465000_2.1.e000241.8","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jer022"},{"key":"2025081612222465000_2.1.e000241.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2005.10.005"},{"key":"2025081612222465000_2.1.e000241.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.11.023"},{"key":"2025081612222465000_2.1.e000241.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.11.029"},{"key":"2025081612222465000_2.1.e000241.12","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000031"},{"key":"2025081612222465000_2.1.e000241.13","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.983510"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2015-000241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T19:22:34Z","timestamp":1755372154000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2015-000241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2015,6,26]]},"published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1136\/openhrt-2015-000241"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2015-000241","relation":{},"ISSN":["2053-3624"],"issn-type":[{"type":"electronic","value":"2053-3624"}],"subject":[],"published":{"date-parts":[[2015,6]]}}}