Key result
Resting aortic valve area index and velocity ratio independently predicted true-severe aortic stenosis, correctly classifying 95.7% of patients when both predictors were present (p<0.001).
Why the study?
DSE is not always feasible in low-gradient severe aortic stenosis, and data on resting echocardiographic predictors for true-severe aortic stenosis are limited.
Do resting echocardiographic parameters (AVAi and VR) predict true-severe aortic stenosis in patients with low-gradient severe aortic stenosis?
Observational (n=106)
Do resting echocardiographic parameters (AVAi and VR) predict true-severe aortic stenosis in patients with low-gradient severe aortic stenosis?
p-value: p=<0.001
Resting aortic valve area index and velocity ratio are independent predictors of true-severe aortic stenosis in patients with low-gradient severe aortic stenosis, which may help identify true severity when dobutamine stress echocardiography is not feasible.
May aid TSAS identification via resting AVAi/VR when DSE infeasible; leaves open prospective validation in low-gradient AS.
Objective Dobutamine stress echocardiography (DSE) is not always feasible in patients with low‐gradient severe aortic stenosis (LG‐SAS), and there are limited data available on the resting echocardiographic predictors for true‐severe aortic stenosis (TSAS). This study investigated resting echocardiographic predictors for TSAS. Methods Clinical data of 106 LG‐SAS patients who underwent DSE were retrospectively analyzed. LG‐SAS was defined as an aortic valve area index (AVAi) < .6 cm 2 /m 2 , and a mean AV pressure gradient < 40 mm Hg. The velocity ratio (VR) was calculated as the peak left ventricular outflow tract velocity/peak AV velocity. TSAS was defined as a projected AVAi < .6 cm 2 /m 2 . Results The mean age was 79.3 ± 7.3 years, and 45 (42.5%) were men. The resting AV data were as follows: AVAi, .50 ± .07 cm 2 /m 2 ; mean AV pressure gradient, 23.0 ± 7.4 mm Hg; and VR, .25 ± .05. The projected AVAi was .58 ± .09 cm 2 /m 2 , and TSAS was documented in 65 (61.3%) patients. In multivariate analysis, the independent predictors of TSAS were AVAi ( p = 0.012) and VR ( p = 0.004) with respective best cut‐off values of .52 cm 2 /m 2 and .25 on receiver‐operating characteristic curve analysis. According to incremental numbers of the predictors, correct classification percentages of TSAS significantly increased with the Cochran‐Armitage trend test (16.2% in no predictors, 65.2% in one predictor, and 95.7 % in two predictors; p < 0.001). Conclusions Resting AVAi and VR were independent predictors of TSAS in LG‐SAS patients. The true severity might be predictable using the combination of resting parameters.
No takes yet. Share an insight, caveat, or question.
Onishi et al. (2021) conducted an observational in Low-gradient severe aortic stenosis (LG-SAS) (n=106). Resting echocardiographic parameters (AVAi and VR) was evaluated on True-severe aortic stenosis (TSAS) defined as a projected AVAi < 0.6 cm2/m2 (p=<0.001). Resting aortic valve area index and velocity ratio independently predicted true-severe aortic stenosis, correctly classifying 95.7% of patients when both predictors were present (p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: