Related Experiment Videos
Progression of aortic stenosis in the elderly detected by noninvasive methods
M Nitta1, T Takamoto, K Taniguchi
12nd Department of Internal Medicine, Faculty of Medicine, Tokyo Medical and Dental University.
Insights
A noninvasive scoring system effectively identifies severe aortic stenosis (AS) and tracks its progression. This tool aids in diagnosing AS severity and monitoring disease advancement in male patients.
Area of Science:
- Cardiology
- Medical Diagnostics
Background:
- Aortic stenosis (AS) is a significant valvular heart disease.
- Accurate assessment of AS severity is crucial for patient management.
- Noninvasive methods are desirable for evaluating AS progression.
Purpose of the Study:
- To evaluate a noninvasive scoring system for diagnosing severe aortic stenosis (AS).
- To assess the system's ability to track AS progression over time.
Main Methods:
- A scoring system based on 7 noninvasive variables was developed.
- The system was applied to 180 male patients referred for cardiac catheterization.
- Patients underwent repeated noninvasive studies and hemodynamic assessments over 3 years.
Main Results:
- A score >= 5 indicated severe AS (aortic valve area <= 1.0 cm2).
- In patients with serial hemodynamic studies, AS progressed significantly over 3 years (p < 0.005).
- Noninvasive scores accurately reflected this progression, increasing from 2.1 to 7.6 (p < 0.005).
- Twenty-two patients with initially mild AS developed scores >= 5 within 3 years, indicating probable progression to severe AS.
Conclusions:
- The noninvasive scoring system is a reliable tool for identifying severe AS.
- The system effectively monitors the progression of aortic stenosis in male patients.
- This noninvasive approach can aid in clinical decision-making for AS management.
Abstract:
One hundred eighty consecutive male patients, mean age of 64.6 years, who were referred to cardiac catheterization for the evaluation of aortic stenosis (AS), were studied using a noninvasive scoring system. The system is based upon 7 variables including: 1) LVH by ECG, 2) aortic valve calcium by chest x-ray, 3) loudness of A2, 4) Q to peak of murmur, 5) T time of the carotid pulse, 6) LV ejection time and 7) LVH by echocardiography. The scoring system has a range from 0 to 16, and a score greater than or equal to 5 indicates severe AS (valve area less than or equal to 1.0 cm2). Eighteen patients had hemodynamic studies on two occasions. In 3 years progression of stenosis was evident by an increase in the mean aortic valve gradient from 23 +/- 3.4 mmHg to 44 +/- 4.2 mmHg (p less than 0.005). The aortic valve area decreased from 1.4 +/- 0.1 cm2 to 0.76 +/- 0.07 cm2 (p less than 0.005). Noninvasive scores increased in these patients from 2.1 +/- 0.5 to 7.6 +/- 1.0 (p less than 0.005). Fifty-one patients had repeated noninvasive studies. Twenty-two patients, who had mild AS at the initial evaluation, attained a score of greater than or equal to 5 in 3 years, indicating probable progression to severe AS. The mean initial score was 2.3 +/- 0.4, and the score at the end of the mean follow-up period of 3 years was 8.0 +/- 0.6 (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)