Outcomes of patients with early calcific aortic valve disease detected by clinically indicated echocardiography
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology..
AIMS: Previous studies have demonstrated relatively slow rates of progression of early calcific aortic valve disease (CAVD), which encompasses aortic sclerosis (ASc) and mild aortic stenosis (AS). The potential evolution to clinically significant AS is unclear, and we therefore examined the long-term outcomes of patients with ASc and mild AS detected at the time of clinically indicated echocardiography.
METHODS AND RESULTS: Data from initial clinically indicated echocardiograms performed between 2010 and 2018 in patients aged ≥18 years were extracted and linked to nationally collected outcome data. Those with impaired right or left systolic ventricular function or other significant left-sided valve disease were excluded. A time to first event analysis was performed with a composite primary outcome of cardiovascular death and aortic valve intervention (AVI). Of the 13 313 patients, 8973 had no CAVD, 3436 had ASc, and 455 had mild AS. The remainder had moderate or worse stenosis. Over a median follow-up period of 4.2 (interquartile range 1.8-6.7) years (and after adjustment for age and sex), those with ASc were at greater risk of the primary outcome [hazard ratio (HR) 2.9, 95% confidence interval (CI) 2.1-4.0] and need for AVI (HR 26.8, 95% CI 9.1-79.1) compared with those with no CAVD. Clinical event rates accelerated after ∼5 years in those with mild AS.
CONCLUSION: Patients with ASc are >25 times more likely to require AVI than those with no CAVD, and follow-up echocardiography should be considered within 3-4 years in those with mild AS.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
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| Enthalten in: |
European heart journal. Cardiovascular Imaging - 25(2024), 3 vom: 22. Feb., Seite 356-364 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Moore, Matthew K [VerfasserIn] |
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| Links: |
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| Themen: |
Aortic sclerosis |
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| Anmerkungen: |
Date Completed 26.02.2024 Date Revised 26.02.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/ehjci/jead259 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363397205 |
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| 245 | 1 | 0 | |a Outcomes of patients with early calcific aortic valve disease detected by clinically indicated echocardiography |
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| 500 | |a Date Revised 26.02.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. | ||
| 520 | |a AIMS: Previous studies have demonstrated relatively slow rates of progression of early calcific aortic valve disease (CAVD), which encompasses aortic sclerosis (ASc) and mild aortic stenosis (AS). The potential evolution to clinically significant AS is unclear, and we therefore examined the long-term outcomes of patients with ASc and mild AS detected at the time of clinically indicated echocardiography | ||
| 520 | |a METHODS AND RESULTS: Data from initial clinically indicated echocardiograms performed between 2010 and 2018 in patients aged ≥18 years were extracted and linked to nationally collected outcome data. Those with impaired right or left systolic ventricular function or other significant left-sided valve disease were excluded. A time to first event analysis was performed with a composite primary outcome of cardiovascular death and aortic valve intervention (AVI). Of the 13 313 patients, 8973 had no CAVD, 3436 had ASc, and 455 had mild AS. The remainder had moderate or worse stenosis. Over a median follow-up period of 4.2 (interquartile range 1.8-6.7) years (and after adjustment for age and sex), those with ASc were at greater risk of the primary outcome [hazard ratio (HR) 2.9, 95% confidence interval (CI) 2.1-4.0] and need for AVI (HR 26.8, 95% CI 9.1-79.1) compared with those with no CAVD. Clinical event rates accelerated after ∼5 years in those with mild AS | ||
| 520 | |a CONCLUSION: Patients with ASc are >25 times more likely to require AVI than those with no CAVD, and follow-up echocardiography should be considered within 3-4 years in those with mild AS | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a aortic sclerosis | |
| 650 | 4 | |a aortic stenosis | |
| 650 | 4 | |a calcific aortic valve disease | |
| 650 | 4 | |a echocardiography | |
| 650 | 4 | |a progression of aortic sclerosis | |
| 700 | 1 | |a Jones, Gregory T |e verfasserin |4 aut | |
| 700 | 1 | |a Whalley, Gillian |e verfasserin |4 aut | |
| 700 | 1 | |a Prendergast, Bernard |e verfasserin |4 aut | |
| 700 | 1 | |a Williams, Michael J A |e verfasserin |4 aut | |
| 700 | 1 | |a Coffey, Sean |e verfasserin |4 aut | |
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