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- Title
How can progression be predicted in patients with mild to moderate aortic valve stenosis?
- Authors
Seo, Jeong Hun; Kim, Kang Hee; Chun, Kwang Jin; Lee, Bong-Ki; Cho, Byung-Ryul; Ryu, Dong Ryeol
- Abstract
Aims The pressure increase per time unit (dP/dt) in aortic stenosis (AS) jet velocity is assumed to have inter-individual variability in the progressive AS stage. We sought to examine the association of aortic valve (AoV) Doppler-derived dP/dt in patients with mild to moderate AS with risk of progression to severe disease. Methods and results A total of 481 patients diagnosed with mild or moderate AS [peak aortic jet velocity (Vmax) between 2 and 4 m/s] according to echocardiographic criteria were included. AoV Doppler-derived dP/dt was determined by measuring the time needed for the pressure to increase at a velocity of the AoV jet from 1 m/s to 2 m/s. During a median follow-up period of 2.7 years, 12 of 404 (3%) patients progressed from mild to severe AS and 31 of 77 (40%) patients progressed from moderate to severe AS. AoV Doppler-derived dP/dt had a good ability to predict risk of progression to severe AS (area under the curve = 0.868) and the cut-off value was 600 mmHg/s. In multivariable logistic regression, initial AoV calcium score (adjusted odds ratio [aOR], 1.79; 95% confidence interval [CI], 1.18–2.73; P = 0.006) and AoV Doppler-derived dP/dt (aOR, 1.52/100 mmHg/s higher dP/dt; 95% CI, 1.10–2.05; P = 0.012) were associated with progression to severe AS. Conclusion AoV Doppler-derived dP/dt above 600 mmHg/s was associated with risk of AS progression to the severe stage in patients with mild to moderate AS. This may be useful in individualized surveillance strategies for AS progression.
- Subjects
DISEASE progression; CONFIDENCE intervals; AORTIC stenosis; SEVERITY of illness index; RISK assessment; DESCRIPTIVE statistics; ODDS ratio; RECEIVER operating characteristic curves; AORTIC valve; LONGITUDINAL method; EVALUATION
- Publication
European Heart Journal - Cardiovascular Imaging, 2023, Vol 24, Issue 9, p1146
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jead099