Prognostic Value of Transvalvular Flow Rate in Aortic Stenosis: Implications for Risk Stratification.
Background: Timing of treatment of aortic stenosis (AS) is of key importance. AS severity is currently determined by transthoracic echocardiography (TTE) with a main focus on mean trans‐aortic gradients. However, echocardiography has its limitations. The transvalvular flow rate (Q), is defined as th...
| Publicado en: | Echocardiography Vol. 42; no. 1; pp. 1 - 11 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jan2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=183918223&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 183918223 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Jan2025 vid: 42 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 183918223 183918223 183918223 10.1111/echo.70077 183918223 ppf: 1 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Prognostic Value of Transvalvular Flow Rate in Aortic Stenosis: Implications for Risk Stratification. aug: au: Bar Gil, Elad M. Sergienko, Ruslan Roguin, Nir Birman, Shoham Kobal, Sergio L. affil: Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben‐Gurion University of the Negev, Beer‐Sheba, Israel sug: subj: Aortic Valve Stenosis Echocardiography Methods Stroke Volume Physiology Severity of Illness Evaluation Risk Assessment Human Male Female Aged Aged, 80 and Over Retrospective Design Record Review Aortic Valve Stenosis Radiography Aortic Valve Stenosis Diagnosis Aortic Valve Stenosis Prognosis Aortic Valve Stenosis Surgery Aortic Valve Stenosis Classification Aortic Valve Stenosis Risk Factors Aortic Valve Stenosis Mortality Mortality Risk Factors Heart Failure Prevention and Control Transcatheter Aortic Valve Implantation Methods Heart Valve Prosthesis Methods Univariate Statistics Multivariate Analysis Multiple Regression Kaplan-Meier Estimator Variable Survival Analysis Statistical Significance Data Analysis Software Descriptive Statistics Aged: 65+ years Aged, 80 & over Male Female ab: Background: Timing of treatment of aortic stenosis (AS) is of key importance. AS severity is currently determined by transthoracic echocardiography (TTE) with a main focus on mean trans‐aortic gradients. However, echocardiography has its limitations. The transvalvular flow rate (Q), is defined as the ratio of stroke volume (SV) to ejection time (ET): Q = SV/ET. Purpose: To examine the prognostic value of aortic transvalvular flow rate (Q), in patients with moderate or severe AS. Methods: Clinical data from 824 patients diagnosed with AS between 2017 and 2020, and followed up until 2022 for four clinical outcomes: mortality, congestive heart failure (CHF), transcatheter aortic valve implantation (TAVI), and surgical aortic valve replacement (SAVR) was used for this retrospective study. Univariate and multivariate regression analyses were performed for the whole cohort and for the moderate AS subgroup, to identify prognostic markers. Kaplan‐Meier survival analysis was conducted for different transvalvular flow rates and AS severities. Results: Findings demonstrate that lower Q is a significant risk factor for all‐cause mortality even when adjusted for other echocardiographic and clinical variables. Survival analysis for the composite outcome occurrence (TAVI, SAVR, CHF, or mortality) and mortality showed significant differences between groups stratified by AS severity and Q (p value <0.0001). Specifically, Q was more substantial in the moderate AS group. Conclusion: Transvalvular flow rate (Q) is independently prognostic for all‐cause mortality. Furthermore, patients with moderate AS and lower Q should be closely monitored. Flow rate assessment should be integrated into the diagnosis, classification, and prognosis framework for AS. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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