Impact of Aortic Valve Calcification and Sex on Hemodynamic Progression and Clinical Outcomes in AS

For this analysis, patients were excluded if they had a decrease in LV function or flow parameters during follow-up: that is, LV ejection fraction 5 ml/m2, or decrease in mean transvalvular flow rate >20 ml/s. Among the 323 patients enrolled (68 ± 3 years of age; 70% men), baseline age, and comor...

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Published in:Journal of the American College of Cardiology 2017-04, Vol.69 (16), p.2096-2098
Main Authors: Tastet, Lionel, MSc, Enriquez-Sarano, Maurice, MD, Capoulade, Romain, PhD, Malouf, Joseph, MD, Araoz, Phillip A., MD, Shen, Mylène, BSc, Michelena, Hector I., MD, Larose, Éric, MD, MSc, Arsenault, Marie, MD, Bédard, Élisabeth, MD, Pibarot, Philippe, DVM, PhD, Clavel, Marie-Annick, DVM, PhD
Format: Article
Language:English
Subjects:
Aged
Aortic stenosis
Aortic valve
Aortic Valve - diagnostic imaging
Aortic Valve - pathology
Aortic Valve - physiopathology
Aortic Valve Stenosis - diagnosis
Aortic Valve Stenosis - physiopathology
Calcification
Calcification (ectopic)
Calcinosis - diagnosis
Calcinosis - physiopathology
Cardiology
Cardiovascular
Cardiovascular disease
Chronic obstructive pulmonary disease
Classification
Clinical outcomes
Confidence intervals
Coronary artery
Coronary artery disease
Diabetes mellitus
Disease Progression
Dyslipidemia
Echocardiography, Doppler
Electrocardiography
Female
Fibrillation
Flow velocity
Hazards
Health hazards
Heart diseases
Hemodynamics - physiology
Humans
Hypertension
Internal Medicine
Likelihood ratio
Lung diseases
Male
Men
Mercury
Multidetector Computed Tomography
Obstructive lung disease
Patients
Reclassification
Sex Factors
Stenosis
Stroke
Stroke volume
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Summary:For this analysis, patients were excluded if they had a decrease in LV function or flow parameters during follow-up: that is, LV ejection fraction 5 ml/m2, or decrease in mean transvalvular flow rate >20 ml/s. Among the 323 patients enrolled (68 ± 3 years of age; 70% men), baseline age, and comorbidities including hypertension, dyslipidemia, diabetes, coronary artery disease, atrial fibrillation, and chronic obstructive pulmonary disease were similar between the rapid progressors group (i.e., MG progression rate >=3.0 mm Hg/year, median for the cohort) and the slow progressors group (all p >= 0.24). After comprehensive multivariable adjustment using Cox proportional hazards analyses, severe AVC (hazard ratio: 1.62; 95% confidence interval: 1.02 to 2.59; p = 0.04) or AVCd (hazard ratio: 2.25; 95% confidence interval: 1.44 to 3.52; p < 0.0001) were independent predictors of valve-related events, provided additive value in all models (likelihood ratio test; all p < 0.05), and improved patients classification in predicting 4-year event-free survival (net reclassification index >20%; both p < 0.01). References 1 V. Nguyen, C. Cimadevilla, C. Estellat, Haemodynamic and anatomic progression of aortic stenosis, Heart, Vol. 101, 2015, 943-947 2 M.A. Clavel, P. Pibarot, D. Messika-Zeitoun, Impact...
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2017.02.037