Small aortic root in aortic valve stenosis: clinical characteristics and prognostic implications
Aims In aortic valve stenosis (AS), having a small aortic root may influence both the assessment of AS severity and the treatment strategy. The aim was to test the prognostic implications of having a small aortic root in AS within a large prospective study. Methods and results We used data from 4.3-...
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| Veröffentlicht in: | European heart journal cardiovascular imaging 2017-04, Vol.18 (4), p.404-412 |
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| creator | Bahlmann, Edda Cramariuc, Dana Minners, Jan Lønnebakken, Mai Tone Ray, Simon Gohlke-Baerwolf, Christa Nienaber, Christoph A. Jander, Nikolaus Seifert, Reinhard Chambers, John B. Kuck, Karl Heinz Gerdts, Eva |
| description | Aims
In aortic valve stenosis (AS), having a small aortic root may influence both the assessment of AS severity and the treatment strategy. The aim was to test the prognostic implications of having a small aortic root in AS within a large prospective study.
Methods and results
We used data from 4.3-year follow-up of 1560 patients with asymptomatic, initially mostly moderate AS enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study. A small aortic root was defined as inner aortic sinotubular junction diameter indexed for body height |
| doi_str_mv | 10.1093/ehjci/jew159 |
| format | Article |
| fullrecord | <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_ehjci_jew159</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ehjci/jew159</oup_id><sourcerecordid>10.1093/ehjci/jew159</sourcerecordid><originalsourceid>FETCH-LOGICAL-c361t-5bd7d8f252911edae694d5cc6e9961fce0655ec0e06ed8326741ae47cf5b28f23</originalsourceid><addsrcrecordid>eNp9kD1PwzAQhi0EolXpxoy8sRBqO7bTsKGKL6kSAzAH175QV04c2WkR_x6XUEZuee-k573hQeickmtKynwG6422sw18UlEeoTEjvMgYp-z4byd8hKYxbkgawSVn9BSNWMFLyvP5GL2_NMo5rHzorcbB-x7b9nDulNsBjj20Ptp4g7WzrdXKYb1WQekego2Ji1i1BnfBfyRu37NN5xLXW9_GM3RSKxdh-psT9HZ_97p4zJbPD0-L22Wmc0n7TKxMYeY1E6ykFIwCWXIjtJZQlpLWGogUAjRJCWaeM1lwqoAXuhYrlnr5BF0Nf3XwMQaoqy7YRoWvipJq76r6cVUNrhJ-MeDddtWA-YMPZhJwOQB-2_3_6hudAXY1</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Small aortic root in aortic valve stenosis: clinical characteristics and prognostic implications</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Bahlmann, Edda ; Cramariuc, Dana ; Minners, Jan ; Lønnebakken, Mai Tone ; Ray, Simon ; Gohlke-Baerwolf, Christa ; Nienaber, Christoph A. ; Jander, Nikolaus ; Seifert, Reinhard ; Chambers, John B. ; Kuck, Karl Heinz ; Gerdts, Eva</creator><creatorcontrib>Bahlmann, Edda ; Cramariuc, Dana ; Minners, Jan ; Lønnebakken, Mai Tone ; Ray, Simon ; Gohlke-Baerwolf, Christa ; Nienaber, Christoph A. ; Jander, Nikolaus ; Seifert, Reinhard ; Chambers, John B. ; Kuck, Karl Heinz ; Gerdts, Eva</creatorcontrib><description>Aims
In aortic valve stenosis (AS), having a small aortic root may influence both the assessment of AS severity and the treatment strategy. The aim was to test the prognostic implications of having a small aortic root in AS within a large prospective study.
Methods and results
We used data from 4.3-year follow-up of 1560 patients with asymptomatic, initially mostly moderate AS enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study. A small aortic root was defined as inner aortic sinotubular junction diameter indexed for body height <1.4 cm/m in women and <1.5 cm/m in men. A small aortic root was found in 270 patients (17.3%) at baseline. Having a small aortic root was associated with larger aortic root wall thickness, higher pressure recovery, lower systemic arterial compliance, left ventricular mass index, and female sex in a multivariable logistic regression analysis (all P < 0.05). In the Cox regression analysis, having a small aortic root at baseline was associated with higher hazard rates of ischaemic cardiovascular events (n = 268; HR 1.55, 95% CI 1.16–2.06), non-haemorrhagic stroke (n = 55; HR 1.88, 95% CI 1.04–3.41), and cardiovascular death (n = 81; HR 2.08, 95% CI 1.28–3.39) (all P < 0.05) after adjusting for confounders, including randomized study treatment, sex, hypertension, AS severity, and aortic valve replacement.
Conclusion
In AS patients without known cardiovascular disease or diabetes, having a small aortic root was associated with increased ischaemic cardiovascular events and mortality. The results suggest a relation between the presence of a small aortic root and that of subclinical atherosclerosis.
Clinical trial registration
ClinicalTrials.gov identifier: NCT00092677.</description><identifier>ISSN: 2047-2404</identifier><identifier>EISSN: 2047-2412</identifier><identifier>DOI: 10.1093/ehjci/jew159</identifier><identifier>PMID: 27491438</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Aged ; Aortic Valve - diagnostic imaging ; Aortic Valve - drug effects ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - drug therapy ; Aortic Valve Stenosis - mortality ; Aortic Valve Stenosis - physiopathology ; Echocardiography ; Ezetimibe - therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Proportional Hazards Models ; Prospective Studies ; Risk Assessment ; Severity of Illness Index ; Simvastatin - therapeutic use ; Survival Rate ; Time Factors ; Treatment Outcome</subject><ispartof>European heart journal cardiovascular imaging, 2017-04, Vol.18 (4), p.404-412</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com. 2016</rights><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-5bd7d8f252911edae694d5cc6e9961fce0655ec0e06ed8326741ae47cf5b28f23</citedby><cites>FETCH-LOGICAL-c361t-5bd7d8f252911edae694d5cc6e9961fce0655ec0e06ed8326741ae47cf5b28f23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27491438$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bahlmann, Edda</creatorcontrib><creatorcontrib>Cramariuc, Dana</creatorcontrib><creatorcontrib>Minners, Jan</creatorcontrib><creatorcontrib>Lønnebakken, Mai Tone</creatorcontrib><creatorcontrib>Ray, Simon</creatorcontrib><creatorcontrib>Gohlke-Baerwolf, Christa</creatorcontrib><creatorcontrib>Nienaber, Christoph A.</creatorcontrib><creatorcontrib>Jander, Nikolaus</creatorcontrib><creatorcontrib>Seifert, Reinhard</creatorcontrib><creatorcontrib>Chambers, John B.</creatorcontrib><creatorcontrib>Kuck, Karl Heinz</creatorcontrib><creatorcontrib>Gerdts, Eva</creatorcontrib><title>Small aortic root in aortic valve stenosis: clinical characteristics and prognostic implications</title><title>European heart journal cardiovascular imaging</title><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><description>Aims
In aortic valve stenosis (AS), having a small aortic root may influence both the assessment of AS severity and the treatment strategy. The aim was to test the prognostic implications of having a small aortic root in AS within a large prospective study.
Methods and results
We used data from 4.3-year follow-up of 1560 patients with asymptomatic, initially mostly moderate AS enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study. A small aortic root was defined as inner aortic sinotubular junction diameter indexed for body height <1.4 cm/m in women and <1.5 cm/m in men. A small aortic root was found in 270 patients (17.3%) at baseline. Having a small aortic root was associated with larger aortic root wall thickness, higher pressure recovery, lower systemic arterial compliance, left ventricular mass index, and female sex in a multivariable logistic regression analysis (all P < 0.05). In the Cox regression analysis, having a small aortic root at baseline was associated with higher hazard rates of ischaemic cardiovascular events (n = 268; HR 1.55, 95% CI 1.16–2.06), non-haemorrhagic stroke (n = 55; HR 1.88, 95% CI 1.04–3.41), and cardiovascular death (n = 81; HR 2.08, 95% CI 1.28–3.39) (all P < 0.05) after adjusting for confounders, including randomized study treatment, sex, hypertension, AS severity, and aortic valve replacement.
Conclusion
In AS patients without known cardiovascular disease or diabetes, having a small aortic root was associated with increased ischaemic cardiovascular events and mortality. The results suggest a relation between the presence of a small aortic root and that of subclinical atherosclerosis.
Clinical trial registration
ClinicalTrials.gov identifier: NCT00092677.</description><subject>Aged</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - drug effects</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - drug therapy</subject><subject>Aortic Valve Stenosis - mortality</subject><subject>Aortic Valve Stenosis - physiopathology</subject><subject>Echocardiography</subject><subject>Ezetimibe - therapeutic use</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Simvastatin - therapeutic use</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>2047-2404</issn><issn>2047-2412</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1PwzAQhi0EolXpxoy8sRBqO7bTsKGKL6kSAzAH175QV04c2WkR_x6XUEZuee-k573hQeickmtKynwG6422sw18UlEeoTEjvMgYp-z4byd8hKYxbkgawSVn9BSNWMFLyvP5GL2_NMo5rHzorcbB-x7b9nDulNsBjj20Ptp4g7WzrdXKYb1WQekego2Ji1i1BnfBfyRu37NN5xLXW9_GM3RSKxdh-psT9HZ_97p4zJbPD0-L22Wmc0n7TKxMYeY1E6ykFIwCWXIjtJZQlpLWGogUAjRJCWaeM1lwqoAXuhYrlnr5BF0Nf3XwMQaoqy7YRoWvipJq76r6cVUNrhJ-MeDddtWA-YMPZhJwOQB-2_3_6hudAXY1</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Bahlmann, Edda</creator><creator>Cramariuc, Dana</creator><creator>Minners, Jan</creator><creator>Lønnebakken, Mai Tone</creator><creator>Ray, Simon</creator><creator>Gohlke-Baerwolf, Christa</creator><creator>Nienaber, Christoph A.</creator><creator>Jander, Nikolaus</creator><creator>Seifert, Reinhard</creator><creator>Chambers, John B.</creator><creator>Kuck, Karl Heinz</creator><creator>Gerdts, Eva</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20170401</creationdate><title>Small aortic root in aortic valve stenosis: clinical characteristics and prognostic implications</title><author>Bahlmann, Edda ; Cramariuc, Dana ; Minners, Jan ; Lønnebakken, Mai Tone ; Ray, Simon ; Gohlke-Baerwolf, Christa ; Nienaber, Christoph A. ; Jander, Nikolaus ; Seifert, Reinhard ; Chambers, John B. ; Kuck, Karl Heinz ; Gerdts, Eva</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-5bd7d8f252911edae694d5cc6e9961fce0655ec0e06ed8326741ae47cf5b28f23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - drug effects</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - drug therapy</topic><topic>Aortic Valve Stenosis - mortality</topic><topic>Aortic Valve Stenosis - physiopathology</topic><topic>Echocardiography</topic><topic>Ezetimibe - therapeutic use</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Simvastatin - therapeutic use</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bahlmann, Edda</creatorcontrib><creatorcontrib>Cramariuc, Dana</creatorcontrib><creatorcontrib>Minners, Jan</creatorcontrib><creatorcontrib>Lønnebakken, Mai Tone</creatorcontrib><creatorcontrib>Ray, Simon</creatorcontrib><creatorcontrib>Gohlke-Baerwolf, Christa</creatorcontrib><creatorcontrib>Nienaber, Christoph A.</creatorcontrib><creatorcontrib>Jander, Nikolaus</creatorcontrib><creatorcontrib>Seifert, Reinhard</creatorcontrib><creatorcontrib>Chambers, John B.</creatorcontrib><creatorcontrib>Kuck, Karl Heinz</creatorcontrib><creatorcontrib>Gerdts, Eva</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>European heart journal cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bahlmann, Edda</au><au>Cramariuc, Dana</au><au>Minners, Jan</au><au>Lønnebakken, Mai Tone</au><au>Ray, Simon</au><au>Gohlke-Baerwolf, Christa</au><au>Nienaber, Christoph A.</au><au>Jander, Nikolaus</au><au>Seifert, Reinhard</au><au>Chambers, John B.</au><au>Kuck, Karl Heinz</au><au>Gerdts, Eva</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Small aortic root in aortic valve stenosis: clinical characteristics and prognostic implications</atitle><jtitle>European heart journal cardiovascular imaging</jtitle><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>18</volume><issue>4</issue><spage>404</spage><epage>412</epage><pages>404-412</pages><issn>2047-2404</issn><eissn>2047-2412</eissn><abstract>Aims
In aortic valve stenosis (AS), having a small aortic root may influence both the assessment of AS severity and the treatment strategy. The aim was to test the prognostic implications of having a small aortic root in AS within a large prospective study.
Methods and results
We used data from 4.3-year follow-up of 1560 patients with asymptomatic, initially mostly moderate AS enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study. A small aortic root was defined as inner aortic sinotubular junction diameter indexed for body height <1.4 cm/m in women and <1.5 cm/m in men. A small aortic root was found in 270 patients (17.3%) at baseline. Having a small aortic root was associated with larger aortic root wall thickness, higher pressure recovery, lower systemic arterial compliance, left ventricular mass index, and female sex in a multivariable logistic regression analysis (all P < 0.05). In the Cox regression analysis, having a small aortic root at baseline was associated with higher hazard rates of ischaemic cardiovascular events (n = 268; HR 1.55, 95% CI 1.16–2.06), non-haemorrhagic stroke (n = 55; HR 1.88, 95% CI 1.04–3.41), and cardiovascular death (n = 81; HR 2.08, 95% CI 1.28–3.39) (all P < 0.05) after adjusting for confounders, including randomized study treatment, sex, hypertension, AS severity, and aortic valve replacement.
Conclusion
In AS patients without known cardiovascular disease or diabetes, having a small aortic root was associated with increased ischaemic cardiovascular events and mortality. The results suggest a relation between the presence of a small aortic root and that of subclinical atherosclerosis.
Clinical trial registration
ClinicalTrials.gov identifier: NCT00092677.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>27491438</pmid><doi>10.1093/ehjci/jew159</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 2047-2404 |
| ispartof | European heart journal cardiovascular imaging, 2017-04, Vol.18 (4), p.404-412 |
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| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Aortic Valve - diagnostic imaging Aortic Valve - drug effects Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - drug therapy Aortic Valve Stenosis - mortality Aortic Valve Stenosis - physiopathology Echocardiography Ezetimibe - therapeutic use Female Follow-Up Studies Humans Male Middle Aged Predictive Value of Tests Proportional Hazards Models Prospective Studies Risk Assessment Severity of Illness Index Simvastatin - therapeutic use Survival Rate Time Factors Treatment Outcome |
| title | Small aortic root in aortic valve stenosis: clinical characteristics and prognostic implications |
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