OBJECTIVE: The study purpose was to assess the usefulness of echocardiographic parameters of aortic stenosis (AS) severity and left ventricular (LV) systolic function to predict mortality in AS. The main hypothesis is that parameters of LV systolic function are the most important independent predictors of mortality, whereas parameters of stenosis severity are not. METHODS: 1065 consecutive patients with AS referred to the echocardiography laboratory and meeting the inclusion/exclusion criteria were included and followed during 5.7 years. The end points were aortic valve replacement (AVR) (n=584), composite of AVR or death (n=932), all-cause mortality (n=550) and cardiovascular mortality (n=398). RESULTS: The most powerful echocardiographic predictors of valve-related events were parameters of AS severity, such as peak aortic jet velocity (VPeak), mean gradient (MG) and aortic valve area (AVA) (all p<0.001). Regarding mortality, the main predictors were LV ejection fraction (LVEF) and stroke volume index (SVi) (p<0.05). After multivariable adjustment, LVEF (p<0.001) and SVi (p=0.02) remained the only echocardiographic predictors of mortality, even after adjustment for symptomatic status. AVA was also associated with mortality, whereas VPeak and MG were not. CONCLUSIONS: The most powerful echocardiographic predictors of mortality are low LVEF and low flow, whereas AS severity parameters predict valve-related events but not overall mortality. Hence, low flow should be integrated in the risk stratification and therapeutic decision-making in patients with AS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
OBJECTIVE: The study purpose was to assess the usefulness of echocardiographic parameters of aortic stenosis (AS) severity and left ventricular (LV) systolic function to predict mortality in AS. The main hypothesis is that parameters of LV systolic function are the most important independent predictors of mortality, whereas parameters of stenosis severity are not. METHODS: 1065 consecutive patients with AS referred to the echocardiography laboratory and meeting the inclusion/exclusion criteria were included and followed during 5.7 years. The end points were aortic valve replacement (AVR) (n=584), composite of AVR or death (n=932), all-cause mortality (n=550) and cardiovascular mortality (n=398). RESULTS: The most powerful echocardiographic predictors of valve-related events were parameters of AS severity, such as peak aortic jet velocity (VPeak), mean gradient (MG) and aortic valve area (AVA) (all p<0.001). Regarding mortality, the main predictors were LV ejection fraction (LVEF) and stroke volume index (SVi) (p<0.05). After multivariable adjustment, LVEF (p<0.001) and SVi (p=0.02) remained the only echocardiographic predictors of mortality, even after adjustment for symptomatic status. AVA was also associated with mortality, whereas VPeak and MG were not. CONCLUSIONS: The most powerful echocardiographic predictors of mortality are low LVEF and low flow, whereas AS severity parameters predict valve-related events but not overall mortality. Hence, low flow should be integrated in the risk stratification and therapeutic decision-making in patients with AS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Mayooran Namasivayam; Paul D Myers; John V Guttag; Romain Capoulade; Philippe Pibarot; Michael H Picard; Judy Hung; Collin M Stultz Journal: Open Heart Date: 2022-05
Authors: Mayooran Namasivayam; Wei He; Timothy W Churchill; Romain Capoulade; Shiying Liu; Hang Lee; Jacqueline S Danik; Michael H Picard; Philippe Pibarot; Robert A Levine; Judy Hung Journal: J Am Coll Cardiol Date: 2020-04-21 Impact factor: 24.094
Authors: Partho P Sengupta; Sirish Shrestha; Nobuyuki Kagiyama; Yasmin Hamirani; Hemant Kulkarni; Naveena Yanamala; Rong Bing; Calvin W L Chin; Tania A Pawade; David Messika-Zeitoun; Lionel Tastet; Mylène Shen; David E Newby; Marie-Annick Clavel; Phillippe Pibarot; Marc R Dweck Journal: JACC Cardiovasc Imaging Date: 2021-05-19
Authors: Edda Bahlmann; Eigir Einarsen; Dana Cramariuc; Helga Midtbø; Costantino Mancusi; Anne Rossebø; Stephan Willems; Eva Gerdts Journal: Open Heart Date: 2021-08
Authors: Stephan M Pio; Mohammed R Amanullah; Steele C Butcher; Kenny Y Sin; Nina Ajmone Marsan; Philippe Pibarot; Nicolas M Van Mieghem; Zee Pin Ding; Philippe Généreux; Martin B Leon; See Hooi Ewe; Victoria Delgado; Jeroen J Bax Journal: Open Heart Date: 2021-06
Authors: Anthony A Bavry; Edward Hess; Stephen W Waldo; Anna E Barón; Dharam J Kumbhani; Deepak L Bhatt; Ambarish Pandey Journal: Clin Cardiol Date: 2020-07-30 Impact factor: 2.882