In patients with asymptomatic aortic stenosis, having a small aortic root was associated with a higher risk of ischaemic cardiovascular events (HR 1.55; 95% CI 1.16-2.06; P<0.05).
Cohort (n=1,560)
Does having a small aortic root increase the risk of cardiovascular events and mortality in patients with asymptomatic aortic stenosis?
In patients with asymptomatic aortic stenosis, a small aortic root is an independent predictor of increased ischaemic cardiovascular events and cardiovascular mortality.
Hazard Ratio: 1.55 (95% CI 1.16–2.06)
p-value: p=< 0.05
AIMS: In aortic valve stenosis (AS), having a small aortic root may influence both the assessment of AS severity and the treatment strategy. The aim was to test the prognostic implications of having a small aortic root in AS within a large prospective study. METHODS AND RESULTS: We used data from 4.3-year follow-up of 1560 patients with asymptomatic, initially mostly moderate AS enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study. A small aortic root was defined as inner aortic sinotubular junction diameter indexed for body height <1.4 cm/m in women and <1.5 cm/m in men. A small aortic root was found in 270 patients (17.3%) at baseline. Having a small aortic root was associated with larger aortic root wall thickness, higher pressure recovery, lower systemic arterial compliance, left ventricular mass index, and female sex in a multivariable logistic regression analysis (all P < 0.05). In the Cox regression analysis, having a small aortic root at baseline was associated with higher hazard rates of ischaemic cardiovascular events (n = 268; HR 1.55, 95% CI 1.16-2.06), non-haemorrhagic stroke (n = 55; HR 1.88, 95% CI 1.04-3.41), and cardiovascular death (n = 81; HR 2.08, 95% CI 1.28-3.39) (all P < 0.05) after adjusting for confounders, including randomized study treatment, sex, hypertension, AS severity, and aortic valve replacement. CONCLUSION: In AS patients without known cardiovascular disease or diabetes, having a small aortic root was associated with increased ischaemic cardiovascular events and mortality. The results suggest a relation between the presence of a small aortic root and that of subclinical atherosclerosis. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00092677.
Bahlmann et al. (Wed,) conducted a cohort in Aortic valve stenosis (n=1,560). Small aortic root vs. Normal or larger aortic root was evaluated on Ischaemic cardiovascular events (HR 1.55, 95% CI 1.16-2.06, p=< 0.05). In patients with asymptomatic aortic stenosis, having a small aortic root was associated with a higher risk of ischaemic cardiovascular events (HR 1.55; 95% CI 1.16-2.06; P<0.05).