Author + information
- Wendy Tsang,
- Ivan Salgo,
- Mark Gajjar,
- Benjamin Freed,
- Lynn Weinert,
- Sandeep Nathan,
- Atman Shah and
- Roberto M. Lang
Due to its high degree of accuracy, the Society of Thoracic Surgeons Predicted Risk of Mortality (STS) score is used for patient selection in transcatheter aortic valve replacement (TAVR). However, STS score requires compilation of 24 parameters. We studied whether transthoracic echocardiographic (TTE) measurements would be comparable to the STS score in predicting mortality in patients with severe aortic stenosis (AS) ineligible for surgical valve replacement.
Baseline demographics, TTE parameters, STS scores and clinical outcomes at 2 years were obtained from 108 (41 male, 67+13 yrs) medically managed inoperable AS patients undergoing TTE from January 2007 to December 2010 with. TTE predictors of mortality were identified from univariate analyses. Decision tree analyses identified the combination of TTE parameters and STS score needed to predict mortality (R, v2.15.1).
One-year mortality was 46%. E/E', left ventricular ejection fraction (LVEF) and 4-chamber global longitudinal strain (GLS-4C) were significant univariate predictors of mortality. Decision tree analysis found that the combination of E/E', LVEF and GLS-4C provided a better predictive model than the STS score (FIGURE).
Although in high-risk AS patients STS score is an excellent predictor of mortality, the combination of E/E', LVEF and GLS-4C is superior. This 3-parameter TTE score offers a practical alternative to the STS score in predicting mortality in medically managed AS patients.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Imaging: Echo – Aortic Valve Diseases
Abstract Category: 18. Imaging: Echo
Presentation Number: 1144-372
- 2013 American College of Cardiology Foundation