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Impact of stroke volume on cardiovascular risk during progression of aortic valve stenosis

Mai Tone Lønnebakken1, Giovanni De Simone2, Sahrai Saeed3

  • 1Department of Clinical Science, University of Bergen, Bergen, Norway.

Heart (British Cardiac Society)
|April 30, 2017
PubMed

Insights

In patients with severe aortic valve stenosis (AS), lower stroke volume indexed for body surface area (SVI) is linked to increased cardiovascular mortality. This finding was consistent even when considering other risk factors.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Clinical Research

Background:

  • Severe aortic valve stenosis (AS) poses a significant risk for cardiovascular (CV) mortality.
  • Low left ventricular (LV) stroke volume is a known risk factor, but its prognostic value during AS progression requires further investigation.

Purpose of the Study:

  • To investigate the association between stroke volume indexed for body surface area (SVI) and major CV events in patients with AS.
  • To assess the impact of SVI on cardiovascular mortality during the progression of aortic stenosis.

Main Methods:

  • Analysis of 1671 patients from the Simvastatin Ezetimibe in Aortic Stenosis (SEAS) study.
  • Cox and time-varying Cox regression analyses were used to assess the association of SVI with major CV events over a median follow-up of 4.3 years.
  • Low SVI was defined as <35 mL/m².

Main Results:

  • 23% of patients had low SVI at baseline, associated with higher age, BMI, and heart rate, and lower LV function parameters.
  • A 5 mL/m² decrease in SVI was associated with a significant increase in the hazard ratio (HR) for major CV events (HR 1.09) and total mortality (HR 1.08).
  • These associations remained significant and independent of major confounders, including age, sex, and LV ejection fraction.

Conclusions:

  • Lower baseline SVI is a significant independent predictor of major CV events and total mortality in patients with AS.
  • In-study changes in SVI also correlate with an increased rate of major CV events.
  • These findings highlight the prognostic importance of SVI in managing patients with aortic valve stenosis.
Abstract

Keywords:
Aortic valve stenosisPrognosisStroke indexStroke volume

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