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Prognostic stratification by conventional echocardiography of patients with aortic stenosis: the "CAIMAN-ECHO score"

Giovanni Cioffi1, Carmine Mazzone, Pompilio Faggiano

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

Echocardiography (Mount Kisco, N.Y.)
|December 12, 2012
PubMed

Insights

A new CAIMAN-ECHO score accurately stratifies risk in asymptomatic aortic stenosis (AS) patients. This simple tool aids in predicting cardiovascular events for better management of moderate-to-severe AS.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Medicine

Background:

  • Asymptomatic aortic stenosis (AS) management requires risk stratification.
  • Prognosis in asymptomatic AS patients can be worse than anticipated.
  • Current guidelines do not recommend surgery for asymptomatic AS patients.

Purpose of the Study:

  • To develop and validate a simple score, CAIMAN-ECHO, for risk stratification in asymptomatic moderate-to-severe AS.
  • To identify key echocardiographic parameters predicting cardiovascular events.
  • To improve prognostic accuracy for asymptomatic AS patients.

Main Methods:

  • Analysis of 141 patients with moderate-to-severe AS followed for 36 months.
  • Defined endpoint: all-cause death, symptom-driven aortic valve replacement, or hospital admission for myocardial infarction/heart failure.
  • Validated the score in a prospective cohort of 143 patients.

Main Results:

  • Higher aortic transvalvular peak jet velocity, calcium score, and observed/predicted left ventricular (LV) mass ratio were associated with adverse events.
  • Developed the CAIMAN-ECHO score based on these parameters.
  • Event-free survival varied significantly across score quartiles (18% to 96%), with 84% and 77% prediction accuracy in original and validation cohorts.

Conclusions:

  • The CAIMAN-ECHO score is a simple and feasible tool.
  • It provides accurate prognostic stratification for asymptomatic moderate-to-severe AS patients.
  • Facilitates better clinical decision-making in this patient group.
Abstract

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