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Syncope is one of the most serious symptoms in aortic valve stenosis (AS). The aim of this study was to assess the impact of clinical characteristics and echocardiographic parameters, including valvuloarterial impedance (Zva), on syncope in patients with AS.
Methods and Results
A total of 460 patients with moderate AS (n = 246, mean transaortic gradient of 25 to 40 mmHg) and severe AS (n = 214, > 40 mmHg) were included in the study. The patients were divided into two groups: those with a history of syncope (n = 92) and those without (n = 368). Aortic valve area index (0.38 vs. 0.40 cm2/m2, p = 0.048) and stroke volume index (34 vs. 40 ml/m2, p < 0.001) were significantly lower and systolic arterial pressure (SAP, 137 vs. 124 mmHg, p < 0.001), mean transaortic gradient (46 vs. 42 mmHg, p = 0.040) and Zva (5.6 vs. 4.4 mmHg/ml/m2, p < 0.001) were significantly higher in patients with a history of syncope than in those without. In multivariate analysis, Zva and SAP were found to be independent predictors of syncope (Table 1). Using receiver operating characteristic curve analysis, Zva ≥ 4.7 mmHg/ml/m2and SAP ≥ 123 mmHg were identified as the best cutoff values to be associated with syncope (Fig. 1).
Zva may be useful to identify patients with an increased risk of syncope and improve clinical decision making in AS. In addition, our data suggest that hypertension control is an important component of syncope risk management in patients with AS.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Valvular Heart Disease: Clinical I – Aortic Stenosis
Abstract Category: 31. Valvular Heart Disease: Clinical
Presentation Number: 1113–89
- 2013 American College of Cardiology Foundation