Valvular heart diseasePrognostic Value of Aortic Valve Area Index in Asymptomatic Patients With Severe Aortic Stenosis
Section snippets
Methods
From 2001 to 2007, asymptomatic patients who underwent transthoracic echocardiography and had severe AS, defined as an AVA of <1.0 cm2, were retrospectively identified for the present study if they had not undergone aortic valve replacement on initial evaluation. The exclusion criteria were a history of coronary artery disease (diagnosed by clinical, electrocardiographic, echocardiographic, and coronary angiographic evaluation), more than mild mitral valve regurgitation or stenosis, more than
Results
The mean duration of follow-up was 36 ± 27 months. Of the study group, 37 patients had an AVAI of ≥0.6 cm2/m2, and 66 patients had an AVAI of <0.6 cm2/m2. Compared to patients with AVAI of ≥0.6 cm2/m2, those with an AVAI <0.6 cm2/m2 did not significantly differ in age, gender, LV ejection fraction, co-morbidities, C-reactive protein, or serum creatinine but exhibited a smaller AVA, higher Vp, greater peak and mean aortic pressure gradient, and larger body surface area. The baseline patient
Discussion
This is the first study to assess the outcomes on the basis of an AVAI. The present study demonstrated that an AVAI of ≥0.6 cm2/m2 was frequently observed in patients with an AVA <1.0 cm2. Patients with an AVAI of ≥0.6 cm2/m2 had better outcomes than those with an AVAI <0.6 cm2/m2. Multivariate analysis showed that an AVAI <0.6 cm2/m2 and Vp >4.0 m/s were significant predictors of adverse cardiac events, but an AVA <0.75 cm2 was not. Patients with an AVAI <0.6 cm2/m2 or peak velocity >4.0 m/s
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Cited by (43)
2020 ACC/AHA guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
2021, Journal of Thoracic and Cardiovascular SurgerySimple echocardiographic scoring in screening aortic stenosis with focused cardiac ultrasonography in the emergency department
2021, Journal of CardiologyCitation Excerpt :The main results of the present study were: 1) the observation of a strong correlation between the visual AS score for POC-echo performed by emergency physicians and the AVAI for STD-echo performed by expert sonographers; 2) a visual AS score ≥3 for POC-echo performed by emergency physicians had an excellent diagnostic accuracy for moderate or severe AS; and 3) the prevalence of new-onset AS-related events during hospitalization was higher in patients with visual AS score ≥3, as assessed by POC-echo in the emergency department, than in those with visual AS score <3. AS is a progressive and life-threatening disease that carries the risk of severe congestive heart failure, cardiogenic shock, or sudden cardiac death in a symptomatic or even in an asymptomatic stage [10,19–21]. Degenerative AS is one of the most common valvular diseases, especially in elderly populations.
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
2021, Journal of the American College of Cardiology