Han Kangning, Shi Dongmei, Yang Lixia, Xie Meng, Zhong Rongrong, Wang Zhijian, Gao Fei, Ma Xiaoteng, Zhou Yujie
Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
Front Cardiovasc Med. 2022 Feb 23;8:812692. doi: 10.3389/fcvm.2021.812692. eCollection 2021.
Mounting evidence indicates that rapid progression of aortic stenosis (AS) is significantly associated with poor prognosis. Whether diabetes accelerates the progression of AS remains controversial.
The purpose of the present study was to investigate whether diabetes was associated with rapid progression of AS.
We retrospectively analyzed 276 AS patients who underwent transthoracic echocardiography at least twice with a maximum interval ≥ 180 days from January 2016 to June 2021. AS severity was defined by specific threshold values for peak aortic jet velocity (V) and/or mean pressure gradient. An increase of V ≥ 0.3 m/s/year was defined as rapid progression. The binary Logistic regression models were used to determine the association between diabetes and rapid progression of AS.
At a median echocardiographic follow-up interval of 614 days, the annual increase of V was 0.16 (0.00-0.41) m/s. Compared with those without rapid progression, patients with rapid progression were older and more likely to have diabetes ( = 0.040 and = 0.010, respectively). In the univariate binary Logistic regression analysis, diabetes was associated with rapid progression of AS (OR = 2.02, = 0.011). This association remained significant in the multivariate analysis based on model 2 and model 3 (OR = 1.93, = 0.018; OR = 1.93, = 0.022). After propensity score-matching according to V, diabetes was also associated rapid progression of AS (OR = 2.57, = 0.045).
Diabetes was strongly and independently associated with rapid progression of AS.
越来越多的证据表明，主动脉瓣狭窄（AS）的快速进展与不良预后显著相关。糖尿病是否会加速AS的进展仍存在争议。
本研究旨在调查糖尿病是否与AS的快速进展有关。
我们回顾性分析了2016年1月至2021年6月期间至少接受过两次经胸超声心动图检查、最大间隔≥180天的276例AS患者。AS的严重程度由主动脉峰值射流速度（V）和/或平均压力梯度的特定阈值定义。V每年增加≥0.3 m/s被定义为快速进展。采用二元Logistic回归模型确定糖尿病与AS快速进展之间的关联。
在超声心动图随访的中位间隔时间为614天时，V的年增长率为0.16（0.00 - 0.41）m/s。与无快速进展的患者相比，快速进展的患者年龄更大，患糖尿病的可能性更高（分别为P = 0.040和P = 0.010）。在单变量二元Logistic回归分析中，糖尿病与AS的快速进展相关（OR = 2.02，P = 0.011）。在基于模型2和模型3的多变量分析中，这种关联仍然显著（OR = 1.93，P = 0.018；OR = 1.93，P = 0.022）。根据V进行倾向得分匹配后，糖尿病也与AS的快速进展相关（OR = 2.57，P = 0.045）。
糖尿病与AS的快速进展密切且独立相关。
