Higher acceleration ejection time ratio predicts impaired prognosis in mild to moderate aortic stenosis. (25th November 2020)

• Record Type: Journal Article
• Authors: Einarsen, E; Cramariuc, D; Bahlmann, E; Midtboe, H; Chambers, J.B; Rossebo, A.B; Gerdts, E
• Is Part Of: European heart journal. Volume 41:(2020)Supplement 2
• Publication Date: 2020-11-25
• Subjects: Aortic Valve Stenosis; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/ehjci/ehaa946.1985
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Introduction: Acceleration/ejection time (AT/ET) ratio is a marker of aortic stenosis (AS) severity, and a predictor of outcome in severe AS. The importance of ejection dynamics in mild and moderate AS has been less investigated. Purpose: To investigate the impact of increased AT/ET ratio on prognosis in patients with mild-moderate AS. Methods: Data from 1635 patients with asymptomatic mild-moderate AS with preserved ejection fraction enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study was analysed. Covariates of higher AT/ET ratio was identified in linear regression analysis. Outcome was assessed in Cox regression analyses and reported as hazard ratio (HR) and 95% confidence interval (CI) per 1 standard deviation (SD) higher AT/ET ratio. Median follow-up time was 4 years. Results: The total study population included 38% female, mean age 67 years and average peak aortic jet velocity was 3.02 m/s. Higher AT/ET ratio was significantly associated with lower ejection fraction, higher LV mass, higher aortic jet velocity, lower systolic blood pressure, low stroke volume index and lower stress-corrected midwall shortening (all p<0.05). In Cox regression analyses, adjusting for these confounders including age and gender, 1 SD higher AT/ET ratio predicted a 29% increase in hazard for major cardiovascular events, 25% for cardiovascular death and hospitalization for heart failure and 23% increase in hazards for all-cause mortality (Table). Conclusion: In asymptomatic mild-moderate AS patients free from diabetes and known cardiovascular disease, higher AT/ET ratio was associated with increased risk for major cardiovascular events, cardiovascular death and hospitalization for heart failure and all-cause mortality independent of traditional risk markers. Funding Acknowledgement: Type of funding source: None