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Left atrial systolic force and outcome in asymptomatic mild to moderate aortic stenosis

Giovanni Cioffi1, Dana Cramariuc, Morten Dalsgaard

  • 1Department of Cardiology, Villa Bianca Hospital, Trento, Italy. gcioffi@villabiancatrento.it

Echocardiography (Mount Kisco, N.Y.)
|June 9, 2012
PubMed

Insights

Higher left atrial systolic force (LASF) indicates a higher risk of cardiovascular events in patients with aortic valve stenosis (AS). This finding helps identify high-risk individuals for better management of AS.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Clinical Research

Background:

  • Chronic pressure overload in hypertension or aortic valve stenosis (AS) is linked to a high-risk cardiovascular (CV) phenotype.
  • Higher left atrial systolic force (LASF) is a recognized indicator of this high-risk CV phenotype.

Purpose of the Study:

  • To evaluate the prognostic value of LASF in patients diagnosed with AS.
  • To determine if LASF can predict major adverse cardiovascular events in individuals with AS.

Main Methods:

  • Analysis of baseline and outcome data from 1,566 patients in the Simvastatin and Ezetimibe in AS (SEAS) study.
  • LASF was calculated using Manning's method, with high LASF defined as exceeding the 95th percentile (>50 Kdynes/cm(2)).
  • Primary outcome was a composite of major CV events, analyzed via multivariate Cox regression.

Main Results:

  • Patients with high LASF experienced a higher rate of major CV events (49%) compared to those with normal LASF (34%) (P = 0.01).
  • High LASF independently predicted an increased rate of major CV events (Hazard ratio 1.43), irrespective of aortic valve area and LV mass index.
  • A risk score incorporating LASF stratified patients into distinct risk categories for CV events.

Conclusions:

  • Elevated LASF provides significant additional prognostic information in patients with asymptomatic, mild-to-moderate AS.
  • LASF can aid in identifying patients at higher risk for adverse cardiovascular outcomes.
Abstract

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