Valvular heart diseaseDifferences in Cardiovascular Risk Profile Between Electrocardiographic Hypertrophy Versus Strain in Asymptomatic Patients With Aortic Stenosis (from SEAS Data)
Section snippets
Methods
All data were from the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study, a multicenter, double-blind, placebo-controlled study investigating whether randomizing 1,873 patients (45 to 85 years of age) with asymptomatic AS (defined as echocardiographic aortic valve thickening accompanied by Doppler-measured aortic peak flow velocity ≥2.5 and ≤4.0 m/s, normal LV systolic function, and absence of symptoms according to independent local investigators based on patient interviews) to
Results
Electrocardiographic data were available for 1,563 patients (958 men, 61.4%; 605 women, 38.7%; mean age 67.4 ± 9.6 years) and echocardiographic data were available for 1,471 of these patients. Patients' mean peak aortic jet velocity was 3.1 ± 0.5 m/s (Table 1). Although the predefined inclusion criterion was peak aortic jet velocity ≥2.5 to ≤4.0 m/s, 84 patients had peak aortic jet velocity >4.0 m/s (severe AS) determined at echocardiographic proof reading in the core laboratory. Differences in
Discussion
This is the first large study to describe how electrocardiographic variables relate to peak aortic jet velocity, the LV and clinical covariates in asymptomatic patients with AS and several findings add to current knowledge. First, peak aortic jet velocity is, independent of echocardiographic LV mass index and clinical covariates, significantly increased in patients with electrocardiographic strain and LV hypertrophy by Sokolow–Lyon voltage criteria. Second, LV mass index is, independent of peak
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The Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study was conducted with financial support from Merck & Co., Inc Whitehouse Station, New Jersey.