Key result
Aortic valve cusp thickness >0.26cm predicts ~17-fold higher odds of progression to aortic stenosis.
Why the study?
Calcific aortic valve disease ranges from aortic valve sclerosis to severe aortic stenosis, but it remains uncertain which patients with sclerosis are at particularly high risk of developing stenosis.
Cohort (n=153)
No
Advanced aortic valve calcification and cusp thickness > 0.26cm on baseline echocardiography independently predict the progression of aortic valve sclerosis to aortic stenosis.
Answers are grounded in this paper and cite their sources.
Cusp thickness >0.26 cm may stratify progression risk in aortic sclerosis; leaves open whether echocardiography-guided monitoring improves outcomes.
Objective We aimed to evaluate echocardiographic parameters to predict CAVD progression. Background Calcific aortic valve disease (CAVD) ranges from aortic valve sclerosis (ASc) with no functional impairment of the aortic valve to severe aortic stenosis (AS). It remains uncertain, which patients with ASc are at particular high risk of developing AS. Methods We included a total of 153 patients with visual signs of ASc and peak flow velocity (Vmax.) below 2.5m/s at baseline echocardiography. Progression of CAVD to AS was defined as an increase of the Vmax. ≥ 2.5m/s with a delta of ≥ 0.1m/s; stable ASc complied with a Vmax. below 2.5m/s and a delta < 0.1m/s. Finally, we compared clinical and echocardiographic parameters between these two groups. Results The mean age at baseline was 73.5 (± 8.2) years and 66.7% were of male gender. After a mean follow-up of 1463 days, 57 patients developed AS, while 96 patients remained in the ASc group. The AS group showed significantly more calcification (p < 0.001) and thickening (p < 0.001) of the aortic valve cusps at baseline, although hemodynamics showed no evidence of AS in both groups (ASc group: Vmax. 1.6 ± 0.3 m/s versus AS group: Vmax. 1.9 ± 0.3 m/s; p < 0.001). Advanced calcification (OR (95% CI): 4.8 (1.5 − 15.9); p = 0.009) and a cusp thickness > 0.26cm (OR (95% CI): 16.6 (5.4 – 50.7); p < 0.001) were independent predictors for the development of AS. Conclusion The acquisition of simple echocardiographic parameter may help to identify patients at particular high risk of developing AS.
No takes yet. Share an insight, caveat, or question.
Shamekhi et al. (2022) conducted a cohort in Aortic valve sclerosis (n=153). Aortic valve cusp thickness > 0.26cm vs. Aortic valve cusp thickness ≤ 0.26cm was evaluated on Progression of calcific aortic valve disease to aortic stenosis (peak flow velocity ≥ 2.5m/s with Δ ≥ 0.1m/s) (OR 16.6, 95% CI 5.4-50.7, p=<0.001). Aortic valve cusp thickness > 0.26cm independently predicted the progression of aortic valve sclerosis to aortic stenosis with an OR of 16.6.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: