OBJECTIVE: We sought to evaluate prognostic markers of clinical outcome in asymptomatic patients with moderate to severe aortic stenosis (AS). DESIGN: Prospective follow-up of asymptomatic patients with moderate to severe AS. The patients underwent clinical and Doppler echocardiographic evaluation. SETTING: Department of Cardiology. PATIENTS: 163 patients with moderate to severe AS (aortic valve area < or =0.6 cm(2)/m(2)). MAIN OUTCOME MEASURES: Risk stratification. Predefined endpoints for assessing the outcome were the occurrence during follow-up of symptoms, aortic valve replacement or death. RESULTS: During follow-up (mean, 20 (19) months), 11 patients developed symptoms but were not operated on, 57 required aortic valve replacement and six patients died. In multivariable Cox regression analysis, four parameters that were associated with the outcome were identified: peak aortic jet velocity, left ventricular systolic (LV) longitudinal deformation, valvulo-arterial impedance and indexed left atrial area. Using receiver-operator characteristic curve analysis, a peak aortic jet velocity > or =4.4 m/s, a LV longitudinal myocardial deformation < or =15.9%, a valvular-arterial impedance > or =4.9 mm Hg/ml per m(2) and an indexed left atrial area > or =12.2 cm(2)/m(2) were identified as the best cut-off values to be associated with events. CONCLUSIONS: In asymptomatic patients with moderate to severe AS, measurements that integrate the ventricular, vascular and valvular components of the disease improve risk stratification.
OBJECTIVE: We sought to evaluate prognostic markers of clinical outcome in asymptomatic patients with moderate to severe aortic stenosis (AS). DESIGN: Prospective follow-up of asymptomatic patients with moderate to severe AS. The patients underwent clinical and Doppler echocardiographic evaluation. SETTING: Department of Cardiology. PATIENTS: 163 patients with moderate to severe AS (aortic valve area < or =0.6 cm(2)/m(2)). MAIN OUTCOME MEASURES: Risk stratification. Predefined endpoints for assessing the outcome were the occurrence during follow-up of symptoms, aortic valve replacement or death. RESULTS: During follow-up (mean, 20 (19) months), 11 patients developed symptoms but were not operated on, 57 required aortic valve replacement and six patients died. In multivariable Cox regression analysis, four parameters that were associated with the outcome were identified: peak aortic jet velocity, left ventricular systolic (LV) longitudinal deformation, valvulo-arterial impedance and indexed left atrial area. Using receiver-operator characteristic curve analysis, a peak aortic jet velocity > or =4.4 m/s, a LV longitudinal myocardial deformation < or =15.9%, a valvular-arterial impedance > or =4.9 mm Hg/ml per m(2) and an indexed left atrial area > or =12.2 cm(2)/m(2) were identified as the best cut-off values to be associated with events. CONCLUSIONS: In asymptomatic patients with moderate to severe AS, measurements that integrate the ventricular, vascular and valvular components of the disease improve risk stratification.
Authors: Yukari Kobayashi; Juyong B Kim; Kegan J Moneghetti; Yuhei Kobayashi; Ran Zhang; Daniel A Brenner; Ryan O'Malley; Ingela Schnittger; Michael Fischbein; D Craig Miller; Alan C Yeung; David Liang; Francois Haddad; William F Fearon Journal: Int J Cardiovasc Imaging Date: 2017-05-17 Impact factor: 2.357
Authors: Andreas Goette; Jonathan M Kalman; Luis Aguinaga; Joseph Akar; Jose Angel Cabrera; Shih Ann Chen; Sumeet S Chugh; Domenico Corradi; Andre D'Avila; Dobromir Dobrev; Guilherme Fenelon; Mario Gonzalez; Stephane N Hatem; Robert Helm; Gerhard Hindricks; Siew Yen Ho; Brian Hoit; Jose Jalife; Young-Hoon Kim; Gregory Y H Lip; Chang-Sheng Ma; Gregory M Marcus; Katherine Murray; Akihiko Nogami; Prashanthan Sanders; William Uribe; David R Van Wagoner; Stanley Nattel Journal: Heart Rhythm Date: 2016-06-10 Impact factor: 6.343
Authors: E Mara Vollema; Tadafumi Sugimoto; Mylène Shen; Lionel Tastet; Arnold C T Ng; Rachid Abou; Nina Ajmone Marsan; Bart Mertens; Raluca Dulgheru; Patrizio Lancellotti; Marie-Annick Clavel; Philippe Pibarot; Philippe Genereux; Martin B Leon; Victoria Delgado; Jeroen J Bax Journal: JAMA Cardiol Date: 2018-09-01 Impact factor: 14.676