Baseline predictors of AVR assignment in asymptomatic* patients with decision (N=392)
| Univariate OR (95% CI) | Univariate p value | Multivariate† OR (95% CI) | Multivariate† p value | |
| Referring by cardio (vs other referring physician) | 1.213 (0.735 to 2.002) | 0.450 | 1.226 (0.678 to 2.216) | 0.501 |
| Age >versus≤80 years | 0.833 (0.546 to 1.271) | 0.396 | 0.695 (0.409 to 1.178) | 0.176 |
| Severe frailty | 0.584 (0.180 to 1.897) | 0.371 | 0.586 (0.129 to 2.655) | 0.488 |
| EuroSCORE II>versus≤2.39% | 0.914 (0.526 to 1.588) | 0.749 | 0.899 (0.431 to 1.872) | 0.775 |
| Comorbidities | ||||
| Renal impairment‡ | 0.717 (0.401 to 1.279) | 0.259 | 0.451 (0.204 to 0.998) | 0.049 |
| COPD | 1.382 (0.521 to 3.663) | 0.515 | 1.588 (0.484 to 5.210) | 0.445 |
| Diabetes§ | 0.406 (0.148 to 1.119) | 0.081 | 0.404 (0.119 to 1.378) | 0.148 |
| Endocarditis | n.a. | n.a. | n.a. | n.a. |
| 2-year life expectancy <25%¶ | 1.843 (0.483 to 7.035) | 0.371 | 0.897 (0.169 to 4.768) | 0.899 |
| Echocardiographic parameters | ||||
| Indexed AVA ≤versus>0.39 cm2/m2 | 2.169 (0.398 to 3.366) | 0.001 | 1.709 (1.012 to 2.886) | 0.045 |
| Vmax >versus≤4.3 m/s | 1.592 (1.045 to 2.426) | 0.030 | 1.227 (0.630 to 2.392) | 0.547 |
| Mean AV gradient >versus≤45.0 mm Hg | 1.493 (0.992 to 2.247) | 0.055 | 1.434 (0.741 to 2.774) | 0.285 |
| LVEF ≤versus>58% | 1.758 (1.152 to 2.681) | 0.009 | 2.815 (1.698 to 4.666) | <0.001 |
| PASP >versus≤37.0 mm Hg | 1.463 (0.917 to 2.333) | 0.110 | 1.593 (0.910 to 2.789) | 0.103 |
| AVA <1 cm2 and mean AV gradient <40 mm Hg | 0.808 (0.477 to 1.370) | 0.429 | 0.960 (0.452 to 2.040) | 0.915 |
| Aortic regurgitation grade III/IV | 0.525 (0.246 to 1.119) | 0.095 | 0.612 (0.235 to 1.592) | 0.314 |
| Mitral regurgitation grade III/IV | 0.440 (0.172 to 1.130) | 0.088 | 0.460 (0.143 to 1.480) | 0.193 |
| Tricuspid regurgitation grade III/IV | 0.671 (0.249 to 1.808) | 0.430 | 0.821 (0.211 to 3.194) | 0.776 |
| LV-ESD >versus≤30.0 mm | 2.251 (1.361 to 3.723) | 0.002 | 2.303 (1.256 to 4.223) | 0.007 |
| LV-EDD >versus≤47.0 mm | 1.691 (1.096 to 2.610) | 0.018 | 1.358 (0.807 to 2.286) | 0.249 |
| IVS>versus≤13.3 mm | 1.007 (0.649 to 1.563) | 0.976 | 0.839 (0.496 to 1.421) | 0.514 |
| PW >versus≤12.0 mm | 1.140 (0.718 to 1.810) | 0.577 | 1.187 (0.679 to 2.076) | 0.547 |
| Relative wall thickness >versus≤0.51 | 0.820 (0.522 to 1.289) | 0.390 | 0.917 (0.537 to 1.565) | 0.750 |
| LV mass >versus≤233.9 g | 1.486 (0.942 to 2.345) | 0.088 | 1.122 (0.658 to 1.914) | 0.673 |
| LV mass indexed >versus≤126.3 g/m2 | 1.364 (0.858 to 2.168) | 0.190 | 1.043 (0.609 to 1.784) | 0.879 |
| LVEF <50% and PASP ≥55 mm Hg | 2.386 (1.311 to 4.343) | 0.004 | 1.543 (0.689 to 3.455) | 0.292 |
All continuous variableswere converted to binary predictors using the median of the overall studypopulation as a cut off.
*Symptomatic defined as having ≥1 of the following (presumed to be AS related): chest pain, shortness of breath, dizziness on exertion/syncope.
†Adjusted for age, diabetes,atrial fibrillation, mean AV gradient, LVEF, PASP, aortic regurgitation grade III/IV, and mitral regurgitation grade III/IV.
‡Creatinine clearance rate <50 mL/minor dialysis.
§Insulin dependent.
¶2-year life expectancy< 25% was assessed by the dedicated nurses and physicians.
AS, aortic stenosis; AV, aortic valve; AVA, aortic valve area; AVR, aortic valve replacement; COPD, chronic obstructive pulmonary disease; IVS, interventricular septum; LV, left ventricular; LV-EDD, left ventricular end diastolic diameter; LVEF, left ventricular ejection fraction; LV-ESD, left ventricular end systolic diameter; PASP, pulmonary artery systolic pressure; PW, posterior wall.