The prognostic value of fQRSTa in patients with aortic stenosis undergoing surgical aortic valve replacement.

Background: Surgical aortic valve replacement (sAVR) is the ultimate therapy for severe aortic stenosis (AS) in suitable patients. Prognostic factors of sAVR are great interest in recent studies. Frontal QRS-T angle (fQRSTa) is a novel marker of ventricular repolarization abnormalities. In this study, we aimed to investigate the prognostic value of fQRSTa in patients with severe symptomatic AS undergoing sAVR.

Methods: A total of 372 patients with severe degenerative AS who underwent successful sAVR were included in this retrospective study. Then, patients were divided into two groups: patients with narrow fQRSTa (≤90°) as group 1 and wide fQRSTa (>90°) as group 2. Perioperative and postoperative clinical evaluation and time of death were recorded from all subjects.

Results: The incidence of total mortality was higher in patients with wider fQRSTa (13.8% [15]; 4.9% [9], P = .013) compared to patients with narrow fQRSTa. In multivariate logistic regression analysis, advanced age (odds ratio [OR] = 1.054; 95% confidence interval [CI] = 1.004-1.106; P = .034), dyspnea (OR = 7.687; 95% CI = 2.296-25.729; P = .001), lower efection fraction (OR = 0.924; 95% CI = 0.884-0.966; P = .001), in-hospital duration (OR = 1.051; 95% CI = 1.016-1.088; P = .004) and wider fQRSTa (OR = 4.029; 95% CI = 1.383-11.740; P = .011) were found to be independent predictors of mortality. Additionally, a Kaplan-Meier survival analysis also revealed that long-term survival was found to be significantly decreased in patients with wider fQRSTa (log-rank P = .014).

Conclusion: fQRSTa was related with poor prognosis in patients with AS undergoing sAVR. fQRSTa was also an independent predictor of mortality in this population.