Abstract 16204: Longitudinal Data Analysis of Echocardiographic Allograft Valve Function
Obective: The assessment of allograft valve performance is complicated by several factors (e.g. unequal number of records per patient, different time intervals between sequential measurements, correlation between measurements). The objective of this study was to describe echocardiographic allograft valve function over time and its determinants in a prospective cohort of patients who underwent allograft aortic valve or root replacement, illustrating the use of longitudinal data analysis for the assessment of valve function over time.
Methods: Serial, standardized echocardiographic records (N=1765) of 301 hospital survivors (mean age 46y; range 16-83) after allograft aortic valve (N=77) or root replacement (N=224) were analyzed using non-linear longitudinal models.
Results: Aortic regurgitation (AR) increased over time (at 15 years 41% of patients had ≥2+ AR) (Figure A). Aortic gradient increased over time (from 9.4 mmHg at 6 months to 21.3 mmHg at 15 years) (Figure C); younger patient age and subcoronary implantation technique were associated with increased aortic regurgitation and aortic gradient (Figure B and D). Anulus diameter slightly increased (from 21.9 mm at 6 months to 22.4 mm at 15 years); younger patients in the subcoronary implantation group had a larger anulus diameter.
Conclusions: Both aortic regurgitation and stenosis increase over time after allograft aortic valve or root replacement, and are the most important cause for allograft failure. Younger patient age and use of the subcoronary implantation technique are associated with increased regurgitation and stenosis. The use of non-linear longitudinal models allows for adequate analysis of allograft valve function over time by revealing the complete temporal pattern and how it’s modulated by patient and procedure related factors.
- © 2012 by American Heart Association, Inc.