Key result
Calcified aortic valve area ≥0.79 cm² predicts MACE and cardiac death in asymptomatic severe AS.
Why the study?
Does the area of calcified aortic valve measured by 2D echocardiography predict future cardiovascular events in asymptomatic severe aortic stenosis patients with preserved LVEF?
Observational (n=124)
Does the area of calcified aortic valve measured by 2D echocardiography predict future cardiovascular events in asymptomatic severe aortic stenosis patients with preserved LVEF?
2D echocardiography-derived area of calcified aortic valve is a simple parameter that can predict future cardiac events in asymptomatic patients with severe aortic stenosis and preserved LVEF.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for 2D echo calcified area in asymptomatic severe AS; should not yet change practice without prospective validation.
We hypothesized that area of calcified aortic valve (ACAV) measured by 2D echocardiography (2DE) can predict future cardiovascular events in asymptomatic severe aortic stenosis (AS).Multidetector computed tomography determined aortic valve calcification load is strongly associated with AS severity but has risks for radiation exposure. Quantification of ACAV by transthoracic 2DE is simple and convenient but its clinical utility has not been extensively studied.We measured ACAV in 124 asymptomatic severe AS patients (80 ± 9 years, 45 males) with preserved left ventricular ejection fraction. ACAV was measured by planimetry from 2D zoomed long axis view of the AV at end-diastole. Patients were followed to record cardiac death (CD) and major adverse cardiovascular events (MACEs).During a median follow-up of 232 days, 17 patients had MACE, including 8 CD. ACAV was significantly larger in patients with event compared to those without (1.14 ± 0.35 cm vs 0.87 ± 0.34 cm, P=.0032). Using receiver operating characteristics derived ACAV of 0.79 cm as cutoff value, Kaplan-Meyer analysis showed it could discriminate high-risk group from low-risk group for future CD (P=.0223, χ = 5.22) and MACE (P = .0054, χ = 7.74).2DE determined ACAV is straightforward and has potential to predict future cardiac events in asymptomatic severe AS patients.
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Wu et al. (2018) conducted an observational in Asymptomatic severe aortic stenosis (n=124). Area of calcified aortic valve (ACAV) by 2D echocardiography vs. ACAV < 0.79 cm² was evaluated on Cardiac death and major adverse cardiovascular events (MACEs) (p=0.0054). An area of calcified aortic valve ≥0.79 cm² by 2D echocardiography predicted future MACE (P=0.0054) and cardiac death (P=0.0223) in asymptomatic severe aortic stenosis.
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