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Initial changes in peak aortic jet velocity and mean gradient predict progression to severe aortic stenosis
Arash Nayeri1, Meng Xu2, Eric Farber-Eger2,3
1University of California, Los Angeles, CA, United States.
International Journal of Cardiology. Heart & Vasculature
|August 8, 2020
Summary
Changes in peak aortic jet velocity (Vmax) and mean gradient (MG) in mild or moderate aortic stenosis (AS) predict progression to severe disease. These findings can help personalize AS surveillance strategies for better patient outcomes.
Area of Science:
- Cardiology
- Echocardiography
- Valvular Heart Disease
Background:
- Aortic stenosis (AS) progression varies significantly between individuals.
- Current surveillance algorithms do not fully account for this variability.
- Predicting AS progression is crucial for timely intervention.
Purpose of the Study:
- To investigate the association between changes in peak aortic jet velocity (Vmax) and mean gradient (MG) and the risk of AS progression.
- To determine if these hemodynamic changes can predict progression to severe aortic stenosis in patients with mild or moderate disease.
Main Methods:
- Adult patients with mild or moderate AS and at least two surveillance echocardiograms were included.
- Changes in Vmax and MG between the first two echocardiograms were measured and indexed to time.
- Multivariable logistic regression was used to assess the association with progression to severe AS.
Main Results:
- Initial increases in Vmax (+0.16 m/s/year) and MG (+1.44 mmHg/year) were observed.
- 15% of patients progressed to severe AS based on Vmax, and 15% based on MG.
- Increased Vmax (OR=4.19) and MG (OR=1.12) were significantly associated with progression to severe AS.
Conclusions:
- Early changes in Vmax and MG are strong predictors of severe AS development.
- These hemodynamic parameters may enhance individualized surveillance strategies for AS patients.
- Personalized monitoring can lead to more effective management of aortic stenosis.
Keywords:
Aortic stenosisEchocardiographyMean gradient (MG)Peak aortic jet velocity (Vmax)ProgressionMore Related Videos
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