Prediction of aortic stenosis-related events in patients with systolic ejection murmur using pocket-sized echocardiography

• Published in: Journal of cardiology 2017-01, Vol.69 (1), p.189-194
• Main Authors: Furukawa, Atsuko, MD, Abe, Yukio, MD, Ito, Makoto, MD, Tanaka, Chiharu, MD, Ito, Kazato, MD, Komatsu, Ryushi, MD, PhD, Haze, Kazuo, MD, PhD, FJCC, Naruko, Takahiko, MD, PhD, FJCC, Yoshiyama, Minoru, MD, PhD, FJCC, Yoshikawa, Junichi, MD, PhD, FJCC
• Format: Article
• Language: English
• Subjects: Aged; Aortic stenosis; Aortic Valve - diagnostic imaging; Aortic Valve - pathology; Aortic Valve - surgery; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - surgery; Calcinosis - complications; Calcinosis - diagnostic imaging; Calcinosis - surgery; Cardiovascular; Echocardiography; Echocardiography - methods; Female; Follow-Up Studies; Heart Valve Prosthesis - statistics & numerical data; Humans; Male; Middle Aged; Pocket-sized imaging device; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Risk Factors; Risk stratification; Severity of Illness Index; Systolic Murmurs - etiology
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2016.02.021

Abstract Background We have previously reported the usefulness of our newly developed visual aortic stenosis (AS) score in screening for AS using pocket-sized echocardiography. The objective of this study was to investigate whether the visual AS score and/or conventional aortic valve calcification score derived from pocket-sized echocardiography can be used to predict AS-related events. Methods One hundred and nine patients with systolic ejection murmur (SEM) or known AS (64 males, age 75 ± 9 years) were enrolled and a visual AS score and an aortic valve calcification score were assessed using pocket-sized echocardiography. The primary endpoint was defined as AS-related events, including cardiac death and aortic valve replacement, during the follow-up period. Results In a multivariate Cox proportional hazards analysis, AS-related events were independently predicted by an aortic valve calcification score ≥3 (HR, 3.5; 95% CI, 1.1–11; p = 0.033) and a visual AS score ≥3 (HR, 15; 95% CI, 1.8–125; p = 0.013). During 18 ± 9 months of follow-up, the event-free survival rate was 98% in patients with both a visual AS score