Prediction of aortic stenosis-related events in patients with systolic ejection murmur using pocket-sized echocardiography

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• 作者：Atsuko Furukawa ; MD^a ; ^{attin9862@hotmail.com} ; Yukio Abe ; MD^a ; Makoto Ito ; MD^a ; Chiharu Tanaka ; MD^a ; Kazato Ito ; MD^a ; Ryushi Komatsu ; MD ; PhD^a ; Kazuo Haze ; MD ; PhD ; FJCC^a ; Takahiko Naruko ; MD ; PhD ; FJCC^a ; Minoru Yoshiyama ; MD ; PhD ; FJCC^b ; Junichi Yoshikawa ; MD ; PhD ; FJCC^c
• 关键词：AS ; aortic stenosis ; AVA ; aortic valve area ; AVAI ; aortic valve area index ; NYHA ; New York Heart Association ; LV ; left ventricular ; SD ; standard deviation ; SEM ; systolic ejection murmur
• 刊名：Journal of Cardiology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：69
• 期：1
• 页码：189-194
• 全文大小：463 K
• 卷排序：69

文摘

We have previously reported the usefulness of our newly developed visual aortic stenosis (AS) score in screening for AS using pocket-sized echocardiography. The objective of this study was to investigate whether the visual AS score and/or conventional aortic valve calcification score derived from pocket-sized echocardiography can be used to predict AS-related events.MethodsOne hundred and nine patients with systolic ejection murmur (SEM) or known AS (64 males, age 75 ± 9 years) were enrolled and a visual AS score and an aortic valve calcification score were assessed using pocket-sized echocardiography. The primary endpoint was defined as AS-related events, including cardiac death and aortic valve replacement, during the follow-up period.ResultsIn a multivariate Cox proportional hazards analysis, AS-related events were independently predicted by an aortic valve calcification score ≥3 (HR, 3.5; 95% CI, 1.1–11; p = 0.033) and a visual AS score ≥3 (HR, 15; 95% CI, 1.8–125; p = 0.013). During 18 ± 9 months of follow-up, the event-free survival rate was 98% in patients with both a visual AS score <3 and an aortic valve calcification score <3, 90% in patients with either a visual AS score ≥3 or an aortic valve calcification score ≥3 (p < 0.0001), and 62% in patients with both a visual AS score ≥3 and an aortic valve calcification score ≥3 (p < 0.0001).ConclusionsThe combination of visual AS score and aortic valve calcification score derived from pocket-sized echocardiography is useful for predicting AS-related events in patients with SEM.