Transvalvular Flow Rate Determines Prognostic Value of Aortic Valve Area in Aortic Stenosis.

Aged Algorithms Aortic Valve / diagnostic imaging Aortic Valve Stenosis / mortality Echocardiography, Doppler Female Follow-Up Studies Heart Valve Prosthesis Implantation / statistics & numerical data Hemodynamics Humans Male Prognosis Sex Factors Stroke Volume / physiology
aortic stenosis flow rate low flow low gradient outcome prognosis

Journal

Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365

Informations de publication

Date de publication:
21 04 2020
Historique:
received: 19 12 2019
revised: 01 02 2020
accepted: 14 02 2020
entrez: 18 4 2020
pubmed: 18 4 2020
medline: 29 12 2020
Statut: ppublish

Résumé

Aortic valve area (AVA) ≤1.0 cm This study aimed to evaluate the effect of flow rate on prognostic value of AVA in AS. In total, 1,131 patients with moderate or severe AS and complete clinical follow-up were included as part of a longitudinal database. The effect of flow rate (ratio of stroke volume to ejection time) on prognostic value of AVA ≤1.0 cm Flow rate had a significant effect on prognostic value of AVA. AVA ≤1.0 cm Transvalvular flow rate determines prognostic value of AVA in AS. AVA measured at low flow rate is not a good prognostic marker and therefore not a good diagnostic marker for truly severe AS. Flow rate assessment should be incorporated into clinical diagnosis, classification, and prognosis of AS.

Sections du résumé

BACKGROUND
Aortic valve area (AVA) ≤1.0 cm
OBJECTIVES
This study aimed to evaluate the effect of flow rate on prognostic value of AVA in AS.
METHODS
In total, 1,131 patients with moderate or severe AS and complete clinical follow-up were included as part of a longitudinal database. The effect of flow rate (ratio of stroke volume to ejection time) on prognostic value of AVA ≤1.0 cm
RESULTS
Flow rate had a significant effect on prognostic value of AVA. AVA ≤1.0 cm
CONCLUSIONS
Transvalvular flow rate determines prognostic value of AVA in AS. AVA measured at low flow rate is not a good prognostic marker and therefore not a good diagnostic marker for truly severe AS. Flow rate assessment should be incorporated into clinical diagnosis, classification, and prognosis of AS.

Identifiants

DOI: 10.1016/j.jacc.2020.02.046 PMID: 32299587 PMC: PMC8087111
pubmed: 32299587
pii: S0735-1097(20)34425-9
doi: 10.1016/j.jacc.2020.02.046
pmc: PMC8087111
mid: NIHMS1580385
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1758-1769

Subventions

Organisme : NHLBI NIH HHS
ID : R01 HL092101
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL141917
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL109506
Pays : United States
Organisme : CIHR
ID : FDN-143225
Pays : Canada
Organisme : CIHR
ID : MOP-114997
Pays : Canada
Organisme : NHLBI NIH HHS
ID : R01 HL128099
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL088942
Pays : United States

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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Auteurs

Mayooran Namasivayam (M)

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: https://twitter.com/MayoNamasivayam.

Wei He (W)

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Timothy W Churchill (TW)

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Romain Capoulade (R)

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, F-44000, Nantes, France; Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.

Shiying Liu (S)

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Hang Lee (H)

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Jacqueline S Danik (JS)

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Michael H Picard (MH)

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Philippe Pibarot (P)

Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.

Robert A Levine (RA)

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Judy Hung (J)

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: jhung@mgh.harvard.edu.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Transvalvular Flow Rate Determines Prognostic...
questionsmedicales.fr › Sciences de l'information › Méthodologies informatiques › Algorithmes › Transvalvular Flow Rate Determines Prognostic...
questionsmedicales.fr › Système cardiovasculaire › Coeur › Valves cardiaques › Valve aortique › Transvalvular Flow Rate Determines Prognostic...
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Obstacle à l'éjection ventriculaire › Sténose aortique › Transvalvular Flow Rate Determines Prognostic...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic cardiovasculaire › Tests de la fonction cardiaque › Échocardiographie › Échocardiographie-doppler › Transvalvular Flow Rate Determines Prognostic...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › Transvalvular Flow Rate Determines Prognostic...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie thoracique › Procédures de chirurgie cardiaque › Implantation de valve prothétique cardiaque › Transvalvular Flow Rate Determines Prognostic...
questionsmedicales.fr › Phénomènes physiologiques respiratoires et circulatoires › Phénomènes physiologiques cardiovasculaires › Hémodynamique › Transvalvular Flow Rate Determines Prognostic...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Transvalvular Flow Rate Determines Prognostic...
questionsmedicales.fr › Diagnostic › Pronostic › Transvalvular Flow Rate Determines Prognostic...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Facteurs épidémiologiques › Facteurs sexuels › Transvalvular Flow Rate Determines Prognostic...
questionsmedicales.fr › Phénomènes physiologiques respiratoires et circulatoires › Phénomènes physiologiques cardiovasculaires › Hémodynamique › Débit cardiaque › Débit systolique › Transvalvular Flow Rate Determines Prognostic...