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BACKGROUND Patients with asymptomatic severe aortic stenosis (AS) are reported to have a benign prognosis and hence the American College of Cardiology/American Heart Association guidelines do not recommend aortic valve replacement (AVR) for patients with isolated asymptomatic severe AS. However, symptoms are subjective and would depend upon patient's life(More)
BACKGROUND Severe pulmonary arterial hypertension in patients with severe aortic stenosis (AS) carries a poor prognosis. There are limited data on the effect of aortic valve replacement (AVR) in these patients. METHODS Our echocardiographic database between 1993 and 2003 was searched for patients with severe AS defined as a Doppler estimated aortic valve(More)
BACKGROUND Pulmonary hypertension complicating severe aortic stenosis increases morbidity and mortality. Causes and mechanisms of this are unclear. METHODS This is a retrospective observational study of 626 patients with severe aortic stenosis who had measurable pulmonary arterial pressure by Doppler echocardiography. Clinical, echocardiographic and(More)
BACKGROUND Severe aortic stenosis (AS) is a surgically correctable condition. However, aortic valve replacement (AVR) is not offered to many patients with severe AS for various reasons. We investigated the profile and survival patterns of patients with severe AS who did not have AVR. METHODS Our echocardiographic database was screened for patients with(More)
BACKGROUND Atrial fibrillation (AF) has been reported to be associated with decreased survival in population-based studies. Its prognostic importance in end-stage heart failure is not clear. METHODS AND RESULTS We investigated the prognostic implications of AF as function of left ventricular (LV) ejection fraction (EF) in 8,931 consecutive patients(More)
OBJECTIVES In the Surgical Treatment for Ischemic Heart Failure trial, surgical ventricular reconstruction plus coronary artery bypass surgery was not associated with a reduction in the rate of death or cardiac hospitalization compared with bypass alone. We hypothesized that the absence of viable myocardium identifies patients with coronary artery disease(More)
BACKGROUND Severe pulmonary hypertension occurs in approximately 10% of patients with severe aortic regurgitation (AR). The potential survival benefit of aortic valve replacement (AVR) in these patients is not known, and was analyzed in a large cohort of patients. METHODS Our echocardiographic data was screened for severe AR patients with severe pulmonary(More)
BACKGROUND Aortic stenosis (AS) is becoming increasingly common with the aging population. Many of these patients have reduced left ventricular (LV) ejection fractions (EF) or low transvalvular gradients resulting in reluctance to offer aortic valve replacement (AVR). METHODS Our echocardiographic database for the period of 1993 to 2003 was screened for(More)
BACKGROUND Mortality in allograft kidney transplant recipients is high, and cardiovascular disease is the leading cause of death in these patients. They have heightened activity of sympathetic and renin-angiotensin systems. We tested the hypothesis that blockade of sympathetic and renin-angiotensin systems in these patients may offer a survival benefit(More)
BACKGROUND Patients with congestive heart failure have an annual mortality of 10% to 20% depending on disease severity. Though one third of these patients have normal left ventricular (LV) ejection fraction (EF), their natural history is poorly defined. Small population-based studies have suggested a more benign prognosis for patients with preserved LVEF.(More)