Key result
Bicuspid aortic valve linked to ~5-fold higher prevalence of aortic stenosis vs tricuspid valve.
Why the study?
Aortic stenosis is frequently diagnosed at a severe stage needing surgery due to a long asymptomatic period, prompting evaluation of its frequency and associated clinical features using echocardiography.
Observational (n=84,851)
No
Absolute Event Rate: 59% vs 12%
p-value: p=<0.0001
Machine learning analysis of over 84,000 echocardiograms demonstrated that age, hypertension, aortic regurgitation, ascending aortic dilatation, and a bicuspid aortic valve are the strongest clinical predictors for the presence of aortic stenosis, aiding in targeted screening strategies.
Bicuspid aortic valve and age predict aortic stenosis in this large cohort; hypothesis-generating for targeted screening pending prospective validation.
Aortic stenosis (AS) is the most commonly diagnosed valvular heart disease, and its prevalence increases with the aging of the general population. However, AS is often diagnosed at a severe stage, necessitating surgical treatment, due to its long asymptomatic period. The objective of this study was to analyze the frequency of AS in a population of cardiovascular patients using echocardiography (ECHO) and to identify clinical factors and features associated with these patient groups. We utilized machine learning methods to analyze 84,851 echocardiograms performed between 2010 and 2018 at the National Medical Research Center named after V.A. Almazov. The primary indications for ECHO were coronary artery disease (CAD) and hypertension (HP), accounting for 33.5% and 14.2% of the cases, respectively. The frequency of AS was found to be 13.26% among the patients (n = 11,252). Within our study, 1544 patients had a bicuspid aortic valve (BAV), while 83,316 patients had a tricuspid aortic valve (TAV). BAV patients were observed to be younger compared to TAV patients. AS was more prevalent in the BAV group (59%) compared to the TAV group (12%), with a p-value of <0.0001. By employing a machine learning algorithm, we randomly identified significant features present in AS patients, including age, hypertension (HP), aortic regurgitation (AR), ascending aortic dilatation (AscAD), and BAV. These findings could serve as additional indications for earlier observation and more frequent ECHO in specific patient groups for the earlier detection of developing AS.
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Irtyuga et al. (2023) conducted an observational in Cardiovascular patients undergoing echocardiography (n=84,851). Bicuspid aortic valve vs. Tricuspid aortic valve was evaluated on Prevalence of aortic stenosis (p=<0.0001). Aortic stenosis was significantly more prevalent in patients with bicuspid aortic valves (59%) compared to tricuspid aortic valves (12%), with age and bicuspid valve acting as key predictors.
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