PubMed · 152133
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
K C Hearn. 1978. Left ventricular hypertrophy.. https://pubmed.ncbi.nlm.nih.gov/152133/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Low-flow states are associated with adverse outcomes in aortic stenosis (AS), but the prognostic value of transvalvular flow rate (TFR) has not been consistently established across studies. This study is a systematic review and meta-analysis of reconstructed time-to-event data was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses. PubMed/MEDLINE, EMBASE, and Cochrane Library were searched for studies (published by November 14, 2025) comparing low versus normal TFR in AS. Data were collected from Kaplan-Meier curves. The primary endpoint was all-cause mortality. Survival was assessed using pooled Kaplan-Meier curves, Cox regression, flexible parametric survival models, and restricted mean survival time (RMST) analysis. A total of 9 studies including 6,494 patients were analyzed; 2,575 (39.7%) had low TFR. At 8 years of follow-up, estimated survival was 34.1% (95% confidence interval [CI] 24.7% to 47%) in the low-TFR group and 63% (95% CI 58.9% to 67.4%) in the normal-TFR group. Low TFR was associated with higher all-cause mortality (hazard ratio 1.59, 95% CI 1.45 to 1.74, p < 0.001). We observed a progressively greater hazard over time, with the hazard ratio approaching 1.9 by 8 years. At 8 years, RMST in the normal-TFR group was 7.37 years (95% CI 7.21 to 7.53 years) versus 5.07 years (95% CI 4.91 to 5.23 years) in the low-TFR group, representing a lifetime loss of 2.3 years in the low-TFR group (ΔRMST -2.30 years, 95% CI -2.53 to -2.07 years, p < 0.001). In patients with AS, low TFR is associated with significantly higher mortality and lifetime loss. These findings support TFR as a clinically meaningful marker for risk stratification in AS.
The Nager syndrome is the most common form of acrofacial dysostosis. Although autosomal dominant and recessive forms of acrofacial dysostosis have been described the molecular etiology of these disorders is unknown. We report on a child with acrofacial dysostosis, critical aortic stenosis, and a deletion of chromosome 1q involving the heterochromatic block and adjacent euchromatin.
BACKGROUND AND METHODS: The goal of this study was to examine the ability of physical examination to predict valvular aortic stenosis severity and clinical outcome in 123 initially asymptomatic subjects (mean age 63 +/- 16 years, 70% men) followed up for a mean of 2.5 +/- 1.4 years. RESULTS: Doppler aortic jet velocity correlated with systolic murmur intensity (P =.003) and timing (P =.0002), a single second heart sound (P =.01), and carotid upstroke delay (P <.0001) and amplitude (P <.0001). However, no physical examination findings had both a high sensitivity and a high specificity for the diagnosis of severe valvular obstruction. Clinical end points were reached in 56 subjects (46%), including 8 deaths and 48 valve replacements for symptom onset. Univariate predictors of outcome included carotid upstroke delay (P =.0008) and amplitude (P =.0006), systolic murmur grade (P <.0001) and peak (P =.0003), and a single second heart sound (P =.003). On multivariate Cox regression analysis, the only physical examination predictor of outcome was carotid upstroke amplitude (P =.0001). CONCLUSIONS: Although physical examination findings correlate with stenosis severity, echocardiography still is needed to exclude severe obstruction reliably when this diagnosis is suspected.