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Article Abstract
Objective: We hypothesised that patients with asymptomatic aortic stenosis (AS) who remain with discordantly graded aortic valve stenosis (DGAS) after adjustment for pressure recovery in the aortic root represents a subgroup of patients with increased cardiovascular risk.
Methods: Data from 1353 patients with asymptomatic mild-moderate AS and preserved left ventricular ejection fraction enrolled in the Simvastatin and Ezetimibe in AS study was used. DGAS was identified as combined pressure adjusted valve area (energy loss) <1.0 cm² and mean aortic gradient<40 mm Hg (DGAS). Outcome was assessed in Cox regression analysis and reported as HR and 95% CI.
Results: DGAS was found in 196 (14.5%) patients at baseline, and was associated with older age, female sex, smaller aortic annulus diameter, lower heart rate, more extensive valve calcification and low flow (all p<0.05). In Cox regression analysis, DGAS was associated with higher rate of heart failure (HF) hospitalisation (HR 3.31 (95% CI 1.54 to 7.09)), cardiovascular death (HR 2.63 (95% CI 1.34 to 5.17)) and all-cause mortality (HR 1.73 (95% CI 1.04 to 2.87)) independent of confounders including low flow and aortic valve calcification (all p<0.05).
Conclusions: Patients with asymptomatic AS who remain with discordant grading after adjustment for pressure recovery have increased risk for HF and death.
Trial Registration Number: NCT00092677.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9703352 | PMC |
| http://dx.doi.org/10.1136/openhrt-2022-002159 | DOI Listing |
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