Restoration of clinical and instrumental parameters of the cardiovascular system in patients with diffuse toxic goiter after resolution of thyrotoxicosis

Rationale:Evaluation of the cardiovascular system in patients with common thyroid disorders could be of interest from the perspective to identify new risk factors for cardiovascular events. Whether cardiovascular abnormalities associated with thyrotoxicosis would be reversible after its treatment, needs elucidation.Aim: To assess the degree of restoration and prerequisites for reversion of the signs and symptoms of cardiac injury in the long term after conservative and surgical cure of thyrotoxicosis in patients with diffuse toxic goiter (DTG).Materials and methods: This was an open longitudinal retrospective study performed in the Regional Center for Endocrine Surgery, Chelyabinsk Municipal Clinical Hospital No. 1 in 124 patients with past history of DTG. By the time of examination, all patients were in a stable clinical and laboratory remission after the withdrawal thyrostatic agents or were in controlled post-operative hypothyroidism for 1.5 to 5 years after surgery for DTG. The mean age of the conservatively treated patients (n=62) was 39.9±1.31 years (19 to 55 years). The mean age of the patients that had been treated surgically (n=62; subtotal thyroid resection) was 41.1±1.4 years (21 to 56 years). We compared with patients' complaints, electrocardiographic and echocardiographic parameters by the time of examination with the corresponding data at the time of the primary referral.Results: In the long term after the elimination of thyrotoxicosis, 56.5% (35/62) of the patients who had underwent surgery, were complaining of dyspnea, 54.8% (34/62) of palpitations, and 50% (31/62) of cardialgias (p<0.01), whereas among the conservatively treated patients the corresponding complaints were present in 59.7% (37/62), 64.5% (40/62), and 56.5% (35/62) (p<0.01). Ninety nine (99) percent of the patients, who had arterial hypertension before the treatment, remained hypertensive at the follow-up. In 30% of the surgically treated patients the severity of arterial hypertension was higher than initially. In the surgery group, there was a decrease in the left atrium diameter in 17 patients and in the end-diastolic diameter of the right ventricle in 24 patients; all these patients did not have hypertension at baseline. No restoration of the heart chamber diameters was seen after conservative treatment and after surgery in patients with arterial hypertension. ST segment and T wave abnormalities were not associated with any clinical symptoms both at baseline and in the long term. At the long term follow up all patients had normal thyroid-stimulating hormone (TSH) and thyroxine (T4) levels, with no associations between TSH and T4 levels and clinical and instrumental assessment results. All patients with past history of DTG continued to have tachycardia, arterial hypertension, diastolic dysfunction and increased left ventricular myocardial mass.Conclusion: Cardiovascular abnormalities persisted for a long time after the elimination of DTG. Arterial hypertension that had arisen against the background of DTG had a negative impact on the structural and functional state of the heart in this disease, irrespective of the treatment method used. In the patients with past history of DTG, we identified such predictors of heart failure as tachycardia, arterial hypertension, diastolic dysfunction, increased left ventricular myocardial mass.

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De Novo Aneurysm: Case Reports and Literature Review

Neurosurgery ◽

10.1227/neu.0b013e3182196489 ◽

2011 ◽

Vol 69 (3) ◽

pp. E761-E767 ◽

Cited By ~ 17

Author(s):

Nunung Nur Rahmah ◽

Tetsuyoshi Horiuchi ◽

Yoshikazu Kusano ◽

Tetsuo Sasaki ◽

Kazuhiro Hongo

Keyword(s):

Arterial Hypertension ◽

De Novo ◽

Past History ◽

Case Reports ◽

Previous History ◽

Anterior Circulation ◽

Risk Of Rupture ◽

History Of ◽

The Mean

Abstract BACKGROUND AND IMPORTANCE: Formation of cerebral de novo aneurysms (CDNAs) is rare, and the pathogenesis remains obscure. We analyzed factors involved in formation of CDNAs and suggest guidelines for follow-up of patients. CLINICAL PRESENTATION: We retrospectively reviewed intracranial aneurysms at our institute and published reports from 1964 to 2008. Eleven patients were found with CDNAs, and 138 patients were collected from the published literature. We assessed the clinical characteristics, such as sex, size, and site of CDNA, past history, and time to occurrence of CDNAs. Of 11 patients, 10 were female and 1 was male; the mean age of the first onset was 53 years (range, 25-69 years). The mean time between first aneurysms and CDNAs was 10.6 years (range, 3-29 years). The most common site of occurrence was anterior circulation. One patient experienced contralateral occurrence, and 2 patients changed from anterior to posterior circulation CDNAs. Six (54.5%) patients had a history of arterial hypertension. Results from analysis of the whole series from the literature revealed that the risk of rupture increased with a previous history of hemorrhage. Contralateral occurrence of CDNAs was related to previous location, and multiplicity, whereas the occurrence of anterior to posterior changes of CDNAs and shorter interval only correlated with an older age group. CONCLUSION: Although the formation of CDNAs is rare, several factors may contribute to its occurrence. Female patients with a history of arterial hypertension were at a higher risk for CDNA occurrence. We recommend follow-up imaging studies within 10 years after the initial aneurysms; therefore, at least 50% of CDNAs can be found before rupture.

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Frequency, Predictors, and Outcome of Seizures in Patients With Myelomeningocele: Single-Center Retrospective Cohort Study

Journal of Child Neurology ◽

10.1177/08830738211053132 ◽

2021 ◽

pp. 088307382110531

Author(s):

Cemal Karakas ◽

Emin Fidan ◽

Kapil Arya ◽

Troy Webber ◽

Joan B. Cracco

Keyword(s):

Good Prognosis ◽

Cortical Atrophy ◽

Seizure Freedom ◽

Single Center ◽

Seizure Onset ◽

Shunt Procedure ◽

History Of ◽

The Mean

To determine the frequency, predictors, and outcomes of seizures in patients with myelomeningocele, we retrospectively analyzed the data from patients with myelomeningocele followed longitudinally at a single center from 1975 to 2013. We identified a total of 122 patients (61% female). The mean follow-up duration was 11.1 years (minimum-maximum = 0-34.5 years, SD = 8.8, median = 9.1 years). A total of 108 (88.5%) patients had hydrocephalus, and 98 (90.7%) of those patients required a ventriculoperitoneal shunt procedure. Twenty-four (19.7%) patients manifested with seizures, 23 of whom had hydrocephalus. The average age of seizure onset was 4.8 years (median 2 years of age). Falx dysgenesis ( P = .004), lumbar myelomeningocele ( P = .007), and cortical atrophy ( P = .028) were significantly associated with epileptic seizure development. The average seizure-free period at the last follow-up in patients with a history of myelomeningocele and seizures was 8.1 years. We conclude that myelomeningocele patients with seizures have an overall good prognosis with considerable long-term seizure freedom.

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Surgical Septal Myectomy for Hypertrophic cardiomyopathy. The Iranian Experience

Asian Cardiovascular and Thoracic Annals ◽

10.1177/02184923211044582 ◽

2021 ◽

pp. 021849232110445

Author(s):

Alireza Alizadeh Ghavidel ◽

Azin Alizadehasl ◽

Ehsan Khalilipur ◽

Ahmadali Amirghofran ◽

Hanieh Nezhadbahram ◽

...

Keyword(s):

Left Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Left Ventricular ◽

Septal Myectomy ◽

Septal Thickness ◽

Long Term Follow Up ◽

Left Ventricular Outflow ◽

The Mean

Introduction Hypertrophic obstructive cardiomyopathy (HOCM) is a hereditary heart muscle disorder characterized by significant myocardial hypertrophy. we assessed perioperative and long-term follow-up data of Iranian HOCM patients who underwent SM in 2 pioneering centers. Methods Clinical data of patients with HOCM septal myectomy are collected. Thirty-day outcome and long-term follow-up data for recurrence of gradient and mortality are reported. Results Ninety-six patients in two different centers enrolled in the study. Most patients of 52 patients in center 1 were male (34/52 [65.3%]).and the mean age was of 36.7 ± 19 years. Syncope before admission was reported in 5.7%, the mean left ventricular ejection fraction on admission was 53 ± 8%, the mean left ventricular outflow tract gradient was 66.3 ± 20.4 mm Hg, and the mean preoperativeseptal thickness was 25.4 ± 6.7 mm. A redo SM was performed in 3 patients (5.8%), mitral valve repair in 5 patients (9.6%), and atrioventricular repair in 5 patients (9.6%). A residual systolic anterior motion was detected in 4 patients (7.7%), the mean postoperative septal thickness was 19 ± 6 mm (25.1% septal thickness reduction), and in-hospital mortality was 5.8% (n = 3). A longer-term follow-up showed death in 3 patients (5.8%) and late recurrent left ventricular outflow tract obstruction in 1 patient. Conclusions Transaortic myectomy is an effective surgery with acceptable early and late mortality rates. Improvements in functional status are seen in almost all patients. Appropriate SM is crucial to a good clinical outcome. Long-term survival is excellent and cardiac sudden death is extremely rare after a good surgical treatment.

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P337Natural history, reversibility and arrhythmias associated with truncating titin variants in dilated cardiomyopathy

European Heart Journal ◽

10.1093/eurheartj/ehz747.0171 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

C R Vissing ◽

T B Rasmussen ◽

M S Olesen ◽

L N Pedersen ◽

A Dybro ◽

...

Keyword(s):

Dilated Cardiomyopathy ◽

Medical Therapy ◽

Ventricular Arrhythmias ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Reverse Remodeling ◽

Absolute Increase ◽

The Mean

Abstract Background Truncating genetic variants in titin (TTNtv) are identified in 15–25% of patients with primary dilated cardiomyopathy (DCM). Previous genotype/phenotype studies have reported conflicting results regarding disease severity and pathologic features associated with TTNtv. Purpose To investigate the natural history, reversibility and burden of arrhythmias associated with TTNtv in a Danish cohort with long-term follow-up. Methods Patients with DCM, recruited from two Danish tertiary centers, were included based on the presence of a TTNtv in a cardiac expressed titin exon. Data on patients' medical history including symptoms, demography, family history, comorbidities, treatment, ECG features, and echocardiograms were registered. Outcome data including all-cause mortality, need of heart transplantation (HTX) or left ventricular assist device (LVAD), and presence of ventricular and supraventricular arrhythmias were registered. Left ventricular reverse remodeling (LVRR) was defined as an absolute increase in left ventricular ejection fraction (LVEF) ≥10% points or normalization. Results A total of 104 patients (71 men, 69%; 72 probands) with definite TTNtv-DCM were included. The mean age at DCM diagnosis was (mean±SD) 45±13 years (43±13 for men; 49±14 for women, p<0.04) and median follow-up was 8.1 years. The mean LVEF was 28±13% at time of diagnosis (26±12% for men; 30±13% for women, p=0.173). During follow-up, 31 patients (30%; 24 men) died or needed HTX/LVAD. Medical therapy was associated with LVRR in 79% of patients 3.6 years after diagnosis. LVRR was maintained long-term in 64% of patients. Women had a better response to medical therapy compared to men (mean LVEF increase 19%; vs 15% in men, p<0.04). Atrial fibrillation/flutter was observed in 40% of patients and ventricular arrhythmias in 23% of patients. Men had an earlier occurrence of both supraventricular and ventricular arrhythmias (p=0.005) with half of the men having experienced an arrhythmia at the age of 54 years. Freedom from arrhythmias with age Conclusion TTNtv leads to a DCM phenotype associated with a marked gender-difference in age at DCM diagnosis and high burden of both supraventricular and ventricular arrhythmias. Importantly, the DCM-TTNtv phenotype was associated with a high degree of reversibility of systolic function following medical therapy.

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Long Term Follow-Up of Pediatric Sickle Cell Disease Patients with Conditional Velocities on Transcranial Doppler (TCD).

Blood ◽

10.1182/blood.v106.11.2338.2338 ◽

2005 ◽

Vol 106 (11) ◽

pp. 2338-2338

Author(s):

Lena Coïc ◽

Suzanne Verlhac ◽

Emmanuelle Lesprit ◽

Emmanuelle Fleurence ◽

Francoise Bernaudin

Keyword(s):

Risk Factors ◽

Color Doppler ◽

Significant Risk ◽

Biological Data ◽

Treatment Intensification ◽

Significant Difference ◽

History Of ◽

The Mean

Abstract Abnormal TCD defined as high mean maximum velocities > 200 cm/sec are highly predictive of stroke risk and justify long term transfusion program. Outcome and risk factors of conditional TCD defined as velocities 170–200 cm/sec remains to be described. Patients and methods Since 1992, 371 pediatric SCD patients (303 SS, 44 SC, 18 Sß+, 6 Sß0) were systematically explored once a year by TCD. The newborn screened cohort (n=174) had the first TCD exploration between 12 and 18 months of age. TCD was performed with a real-time imaging unit, using a 2 MHz sector transducer with color Doppler capabilities. Biological data were assessed at baseline, after the age of 1.5 years and remotely of transfusion or VOC. We report the characteristics and the outcome in patients (n=43) with an history of conditional TCD defined by mean maximum velocities ranging between 170 and 200 cm/s in the ACM, the ACA or the ICA. Results: The mean follow-up of TCD monitoring was 5,5 years (0 – 11,8 y). All patients with an history of conditional doppler were SS/Sb0 (n=43). Mean (SD) age of patients at the time of their first conditional TCD was 4.3 years (2.2) whereas in our series the mean age at abnormal TCD (> 200 cm/sec) occurrence was 6.6 years (3.2). Comparison of basal parameters showed highly significant differences between patients with conditional TCD and those with normal TCD: Hb 7g4 vs 8g5 (p<0.001), MCV 82.8 vs 79 (p=0.047). We also had found such differences between patients with normal and those with abnormal TCD (Hb and MCV p< 0.001). Two patients were lost of follow-up. Two patients died during a trip to Africa. Conditional TCD became abnormal in 11/43 patients and justified transfusion program. Mean (SD) conversion delay was 1.8 (2.0) years (range 0.5–7y). No stroke occurred. 16 patients required a treatment intensification for other indications (frequent VOC/ACS, splenic sequestrations): 6 were transplanted and 10 received HU or TP. Significant risk factors (Pearson) of conversion to abnormal were the age at time of conditional TCD occurrence < 3 y (p<0.001), baseline Hb < 7g/dl (p=0.02) and MCV > 80 (p=0.04). MRI/MRA was performed in 31/43 patients and showed ischemic lesions in 5 of them at the mean (SD) age of 7.1 y (1.8) (range 4.5–8.9): no significant difference was observed in the occurrence of lesions between the 2 groups. Conclusions This study confirms the importance of age as predictive factor of conditional to abnormal TCD conversion with a risk of 64% when first conditional TCD occured before the age of 3 years. TCD has to be frequently controled during the 5 first years of life.

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Long-term follow-up: tuberculosis, bronchiectasis and chronic pulmonary aspergillosis

Pneumologia ◽

10.2478/pneum-2019-0020 ◽

2019 ◽

Vol 68 (3) ◽

pp. 138-143

Author(s):

Oxana Munteanu ◽

Dumitru Chesov ◽

Doina Rusu ◽

Irina Volosciuc ◽

Victor Botnaru

Keyword(s):

Past History ◽

Natural Evolution ◽

Pulmonary Aspergillosis ◽

Long Term Follow Up ◽

History Of ◽

Chronic Pulmonary Aspergillosis ◽

The Impact

Abstract Pulmonary sequelae related to tuberculosis (TB) are among the major causes of bronchiectasis in Eastern Europe. The role of bacterial colonisation in the pathogenesis of bronchiectasis has been continuously studied over the last decades, less understood remains the impact of fungal infection, alone or in association with bacterial. Although the data on the development of chronic pulmonary aspergillosis (CPA) secondary to TB are scarce, recent evidence suggests a higher prevalence of CPA in patients with a past history of pulmonary TB than it was previously estimated. We present a case of natural evolution of CPA, with a radiological follow-up, in a patient with post-tuberculous bronchiectasis.

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Abstract 4427: Electrocardiographic Left Ventricular Hypertrophy Predicts Long Term Fatal Outcomes in Elderly Hypertensives Despite Diuretic-Based Antihypertensive Treatment: 14-Year Follow-Up of the Systolic Hypertension in the Elderly Program (SHEP)

Circulation ◽

10.1161/circ.118.suppl_18.s_887-c ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Tudor Vagaonescu ◽

Alan C Wilson ◽

John B Kostis

Keyword(s):

Antihypertensive Treatment ◽

Ventricular Hypertrophy ◽

Previous History ◽

The Elderly ◽

Cardiovascular Death ◽

Left Ventricular ◽

All Cause Mortality ◽

History Of

Background: To assess if diuretic-based antihypertensive treatment improves long term fatal (cardiovascular) outcomes in the elderly with isolated systolic hypertension (ISH) and ECG documented left ventricular hypertrophy (LVH). Methods: Retrospective analysis of the SHEP database of 4,736 patients age ≥60 years and ISH and subsequent vital status ascertainment by matching to the National Death Index. Results: 348 subjects (7.35%) of SHEP participants had ECG documented LVH at baseline. Subjects with LVH had at baseline: higher SBP and pulse pressure (p<0.0001), carotid bruits (13% vs. 7%, p<0.0001) and previous history of myocardial infarction (8% vs. 4%, p=.0008) when compared with participants without LVH. There were no significant differences with regard to age, sex, heart rate, body mass index, smoking and alcohol use, previous history of stroke, diabetes, angina, and assignment to treatment or placebo group. Over 14.3 years (mean) of follow up subjects with baseline LVH experienced significantly more all cause mortality (51% vs. 40%, p<0.0001) and cardiovascular death (24% vs. 19%, p=0.002) than participants without baseline LVH. In the group of participants with LVH at baseline active treatment of hypertension did not decrease all cause mortality (51% vs. 50%, NS) or cardiovascular death (26% vs. 24%, NS). There was no statistically significant interaction between LVH and the assignment to treatment (antihypertensive medication vs. placebo). In a multivariable analysis, the adjusted Cox hazard ratio of developing any fatal outcome in the LVH group was 1.181 (95% CI 1.005–1.387, p=0.043) after adjusting for age, sex, race, history of myocardial infarction, diabetes, alcohol smoking status, education, blood pressure, and assignment to treatment or to placebo group. Conclusion: In the elderly with ISH the presence of LVH documented by ECG increased the risk for long term fatal outcomes despite treatment with diuretic-based antihypertensive therapy. Although active treatment lowered risk in the SHEP study, treated participants with LVH had a higher risk for fatal outcomes than treated subjects without LVH.

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Abstract 16647: Surgical Cryoablation of Ventricular Tachycardia at the Time of LVAD Implantation

Circulation ◽

10.1161/circ.132.suppl_3.16647 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Erica S Zado ◽

Pasquale Santangeli ◽

Gregory Supple ◽

Brian Betensky ◽

Michael Riley ◽

...

Keyword(s):

Ventricular Tachycardia ◽

Left Ventricular ◽

Assist Device ◽

Surgical Ablation ◽

Ventricular Assist ◽

Antiarrhythmic Drug Therapy ◽

Left Ventricular Assist ◽

History Of ◽

The Mean

Introduction: Patients (pts) with advanced heart failure (HF) undergoing implantation of a left ventricular assist device (LVAD) are at high risk of recurrent ventricular tachycardia (VT). We report the outcome of surgical VT cryoablation (VT CA) at the time of LVAD insertion in pts with advanced HF and drug-refractory VT. Hypothesis: Outcome will be enhanced with pre-operative mapping. Methods: We included consecutive patients with advanced HF and recurrent VT refractory to antiarrhythmic drug therapy and/or conventional catheter ablation, who underwent LVAD implantation and concomitant surgical VT CA. Results: The cohort included 6 pts (5 [83%] male, age 62±10 years) with ischemic (4, 67%) or nonischemic (2, 33%) cardiomyopathy. The mean LVEF prior to surgery was 19±7% (10-27%). All patients had history of recurrent VT, with 4 (67%) pts presenting in VT storm. All were on amiodarone, 1 on oral and the others on IV amiodarone along with IV lidocaine prior to surgery. Four pts (67%) had preoperative detailed electroanatomic mapping (EAM) of the VT substrate, which was used to guide surgical ablation. Cryo lesions were deployed endocardially using the LV apical core as access and/or epicardially to areas identified as scar visually complemented by preop EAM when available (figure). There were no complications related to the CA. Over a follow-up 10.3±12.7 months (range 2-35 months), 4 pts (67%) had no VT, 1 pt had 2 ATP-terminated episodes at 2 months and 1 pt had significant reduction of VT burden (from 11 shocks before surgery to 1 shock at follow-up). The 2 pts with recurrences did not have pre-operative mapping prior to surgical ablation. One patient died of non-cardiac causes at 7 months and 2 patients underwent heart transplant at 10 and 35 months. Conclusions: In pts with advanced HF and refractory VT, surgical ablation can be safely and effectively accomplished at the time of LVAD implantation. When ablation is guided by pre-operative EAM, the outcome may be enhanced.

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Impact of recurrent mitral regurgitation after mitral valve repair for functional mitral regurgitation: long-term analysis of competing outcomes

European Heart Journal ◽

10.1093/eurheartj/ehz306 ◽

2019 ◽

Vol 40 (27) ◽

pp. 2206-2214 ◽

Cited By ~ 8

Author(s):

Annelieke H J Petrus ◽

Olaf M Dekkers ◽

Laurens F Tops ◽

Eva Timmer ◽

Robert J M Klautz ◽

...

Keyword(s):

Mitral Valve ◽

Mitral Regurgitation ◽

Mitral Valve Repair ◽

Left Ventricular ◽

Functional Mitral Regurgitation ◽

Valve Repair ◽

History Of ◽

The Impact

Abstract Aims Recurrent mitral regurgitation (MR) has been reported after mitral valve repair for functional MR. However, the impact of recurrent MR on long-term survival remains poorly defined. In the present study, mortality-adjusted recurrent MR rates, the clinical impact of recurrent MR and its determinants were studied in patients after mitral valve repair with revascularization for functional MR in the setting of ischaemic heart disease. Methods and results Long-term clinical and echocardiographic outcome was evaluated in 261 consecutive patients after restrictive mitral annuloplasty and revascularization for moderate to severe functional MR, between 2000 and 2014. The cumulative incidence of recurrent MR ≥ Grade 2, assessed by competing risk analysis, was 9.6 ± 1.8% at 1-year, 20.3 ± 2.5% at 5-year, and 27.6 ± 2.9% at 10-year follow-up. Cumulative survival was 85.8% [95% confidence interval (CI) 81.0–90.0] at 1-year, 67.3% (95% CI 61.1–72.6%) at 5-year, and 46.1% (95% CI 39.4–52.6%) at 10-year follow-up. Age, preoperative New York Heart Association Class III or IV, a history of renal failure, and recurrence of MR expressed as a time-dependent variable [HR 3.28 (1.87–5.75), P < 0.001], were independently associated with an increased mortality risk. Female gender, a history of ST-elevation myocardial infarction, a preoperative QRS duration ≥120 ms, a higher preoperative MR grade, and a higher indexed left ventricular end-systolic volume were independently associated with an increased likelihood of recurrent MR. Conclusion Mitral valve repair for functional ischaemic MR resulted in a low incidence of recurrent MR with favourable clinical outcome up to 10 years after surgery. Presence of recurrent MR at any moment after surgery proved to be independently associated with an increased risk for mortality.

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The importance of comorbidities for long-term outcome after aortic valve intervention in patients with preserved left ventricular ejection fraction, a nation-wide register study

European Heart Journal ◽

10.1093/ehjci/ehaa946.1939 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Thilen ◽

S James ◽

L Lindhagen ◽

E Stahle ◽

C Christersson

Keyword(s):

Postoperative Outcome ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Term Outcome ◽

Ventricular Ejection Fraction ◽

Long Term Outcome ◽

Cardiovascular Comorbidities ◽

History Of

Abstract Background In Aortic stenosis (AS) cardiovascular comorbidities as well as left ventricular ejection fraction (LVEF) have an impact on postoperative outcome among patients undergoing aortic valve replacement (AVR). The prevalence of heart failure (HF) based on LVEF in patients with severe AS varies. Lately HF with preserved LVEF has gained more attention. The aim is to describe the prevalence and prognostic impact of cardiovascular comorbidities, including HF, in relation to LVEF before AVR in a national cohort of patients with AS. Methods Patients >18 years, undergoing AVR due to AS 2008–2014 were identified in the national register for heart diseases, SWEDEHEART. Preoperative LVEF and comorbidities were collected from the register and enriched with data from national patient registries. The outcome events were all cause mortality and hospitalization for HF as the main diagnosis. The cohort was separated by preoperative LVEF status; preserved (>50%) or reduced (≤50%). Outcome events were analysed by Cox regression. Results 10406 patients, median age 73 (18–96) years whereof 3817 (36.7%) women, were included with a median follow-up of 35 months. In the cohort 15.9%, 73.9% and 10.2% received a mechanical, surgical biological and trans-catheter biological valve prosthesis, respectively. Preserved LVEF was present in 7512 (72.2%). Comorbidities were more frequent in the group with reduced LVEF (p<0.001). Irrespective of LVEF HF influenced outcome negatively (see table). Conclusion In patients planned for AVR a history of HF irrespective of LVEF worsen postoperative prognosis and a history of HF seems at least as important as LVEF when predicting long-term outcome. When stratifying patients for AVR with preserved LVEF, comorbidities such as HF and atrial fibrillation should be highlighted, and further research to identify risk factors for a negative postoperative outcome in this group seems important in optimizing the follow-up after AVR. Funding Acknowledgement Type of funding source: None

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