Author + information
- Yan Fan,
- Brandon Stacey,
- David Zhao,
- Robert Applegate,
- Sujethra Vasu,
- Bharathi Upadhya,
- Peter Flueckiger,
- Pallavi Gomadam and
- Min Pu
Background: Patients (pts) with low gradient severe aortic stenosis (LG SAS) and preserved left ventricular ejection fraction diagnosed by echo have discrepant prognosis leading to different clinical management. We hypothesized that increased mortality in LG SAS may be related to comorbidities and surgical risks defined by the STS score and EuroSCORE II.
Methods: The study included 230 pts with LG SAS. Risks were assessed by the STS and EuroSCORE II. Pts were divided into high-risk (STS ≥4%, n=114 or EuroSCORE II≥3.5%, n=93) or low-risk groups (STS<4%, n=116 or EuroSCORE II<3.5%, n=137). Sixty pts with moderate AS were used for a control group. The pts were followed up for mean 2 years (2±1.1). Primary endpoint was all-cause mortality.
Results: There were no significant differences in echocardiographic AS severity (mean gradients: STS score 21±9.5 vs 19±8.6mmHg, EuroSCORE II 20±9.4 vs 20±8.5mmHg and aortic valve areas: STS score 0.87±0.1 vs 0.84±0.1cm2, EuroSCORE II 0.87±0.1 vs 0.83±0.1cm2, all p>0.05) between the low-risk and high-risk groups. Two-year survival was lower in the high-risk pts than in the low-risk pts (STS score: 64% vs. 83%, p=0.001; EuroSCORE II: 62% vs. 81%, p<0.001. Figure). There was no significant difference in survival between the pts with moderate AS and the low-risk LA SAS (STS score: 88% vs. 83%, p=0.27; EuroSCORE II: 88% vs. 81%, p=0.16).
Conclusions: High risk LG SAS carries poorer prognosis than low-risk LG SAS and moderate AS suggesting that early intervention should be considered.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Valvular Heart Disease: Aortic Stenosis
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1233-025
- 2017 American College of Cardiology Foundation