Prognostic Stratification by Conventional Echocardiography of Patients with Aortic Stenosis: The "CAIMAN-ECHO Score"
Background and Aim: Surgery is not recommended in asymptomatic patients with aortic stenosis (AS). However, prognosis of these patients is worse than retained. We built a simple score (named by the acronym “CAIMAN”) for stratifying asymptomatic patients with AS according to the different risk for ca...
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| Veröffentlicht in: | Echocardiography (Mount Kisco, N.Y.) N.Y.), 2013-04, Vol.30 (4), p.367-377 |
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| creator | Cioffi, Giovanni Mazzone, Carmine Faggiano, Pompilio Tarantini, Luigi Di Lenarda, Andrea Russo, Tiziano Edoardo Selmi, Alessandro Stefenelli, Carlo Furlanello, Francesco |
| description | Background and Aim: Surgery is not recommended in asymptomatic patients with aortic stenosis (AS). However, prognosis of these patients is worse than retained. We built a simple score (named by the acronym “CAIMAN”) for stratifying asymptomatic patients with AS according to the different risk for cardiovascular events. Material and Methods: Data from 141 patients with moderate‐to‐severe AS followed up for 36 months were analyzed. The end point “outcome” was defined as death of all causes or aortic valve replacement imposed by symptoms or hospital admission for myocardial infarction and/or heart failure. The score was validated in 143 patients prospectively recruited in 2 different centers. Results: The 40 events occurred in the original cohort were associated with higher aortic transvalvular peak jet velocity, calcium score, and observed/predicted left ventricular (LV) mass ratio. Based on the hazard ratios of Cox analysis, the score was calculated as follows: calcium score 1–3 = 1 point, 4 = 6 points; transvalvular peak jet velocity ≤3.6 m/sec = 1 point, 3.6 m/sec = 3 points, observed/predicted LV mass ratio ≤110% = 1 point, >110% = 3 points. After a mean period of 28 ± 18 months, event‐free survival was 18%, 42%, 91%, and 96% in the 4 quartiles of echo score. The accuracy of the score in predicting events was 84% and 77% (P = 0.09) in the original and validation cohort, respectively. Conclusions: The CAIMAN‐ECHO score is a simple and feasible tool useful for an accurate prognostic stratification of patients with asymptomatic moderate‐to‐severe AS. |
| doi_str_mv | 10.1111/echo.12065 |
| format | Article |
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However, prognosis of these patients is worse than retained. We built a simple score (named by the acronym “CAIMAN”) for stratifying asymptomatic patients with AS according to the different risk for cardiovascular events. Material and Methods: Data from 141 patients with moderate‐to‐severe AS followed up for 36 months were analyzed. The end point “outcome” was defined as death of all causes or aortic valve replacement imposed by symptoms or hospital admission for myocardial infarction and/or heart failure. The score was validated in 143 patients prospectively recruited in 2 different centers. Results: The 40 events occurred in the original cohort were associated with higher aortic transvalvular peak jet velocity, calcium score, and observed/predicted left ventricular (LV) mass ratio. Based on the hazard ratios of Cox analysis, the score was calculated as follows: calcium score 1–3 = 1 point, 4 = 6 points; transvalvular peak jet velocity ≤3.6 m/sec = 1 point, 3.6 m/sec = 3 points, observed/predicted LV mass ratio ≤110% = 1 point, >110% = 3 points. After a mean period of 28 ± 18 months, event‐free survival was 18%, 42%, 91%, and 96% in the 4 quartiles of echo score. The accuracy of the score in predicting events was 84% and 77% (P = 0.09) in the original and validation cohort, respectively. Conclusions: The CAIMAN‐ECHO score is a simple and feasible tool useful for an accurate prognostic stratification of patients with asymptomatic moderate‐to‐severe AS.</description><identifier>ISSN: 0742-2822</identifier><identifier>EISSN: 1540-8175</identifier><identifier>DOI: 10.1111/echo.12065</identifier><identifier>PMID: 23227935</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Aged ; aortic stenosis ; aortic valve disease severity ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - mortality ; Aortic Valve Stenosis - surgery ; calcium score ; Comorbidity ; Echocardiography - statistics & numerical data ; Female ; Heart Failure - diagnostic imaging ; Heart Failure - mortality ; Heart Valve Prosthesis Implantation - mortality ; Heart Valve Prosthesis Implantation - utilization ; Humans ; inappropriate left ventricular mass ; Incidence ; Italy - epidemiology ; Longitudinal Studies ; Male ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - mortality ; Prognosis ; Reproducibility of Results ; Risk Factors ; Sensitivity and Specificity ; Severity of Illness Index ; Single-Blind Method ; Survival Analysis ; Survival Rate ; Treatment Outcome</subject><ispartof>Echocardiography (Mount Kisco, N.Y.), 2013-04, Vol.30 (4), p.367-377</ispartof><rights>2012, Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3675-810817291c271829f7a4cc23322d00ab8b0e6ed576f654924797552bdc6e9b6a3</citedby><cites>FETCH-LOGICAL-c3675-810817291c271829f7a4cc23322d00ab8b0e6ed576f654924797552bdc6e9b6a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fecho.12065$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fecho.12065$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23227935$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cioffi, Giovanni</creatorcontrib><creatorcontrib>Mazzone, Carmine</creatorcontrib><creatorcontrib>Faggiano, Pompilio</creatorcontrib><creatorcontrib>Tarantini, Luigi</creatorcontrib><creatorcontrib>Di Lenarda, Andrea</creatorcontrib><creatorcontrib>Russo, Tiziano Edoardo</creatorcontrib><creatorcontrib>Selmi, Alessandro</creatorcontrib><creatorcontrib>Stefenelli, Carlo</creatorcontrib><creatorcontrib>Furlanello, Francesco</creatorcontrib><title>Prognostic Stratification by Conventional Echocardiography of Patients with Aortic Stenosis: The "CAIMAN-ECHO Score"</title><title>Echocardiography (Mount Kisco, N.Y.)</title><addtitle>Echocardiography</addtitle><description>Background and Aim: Surgery is not recommended in asymptomatic patients with aortic stenosis (AS). However, prognosis of these patients is worse than retained. We built a simple score (named by the acronym “CAIMAN”) for stratifying asymptomatic patients with AS according to the different risk for cardiovascular events. Material and Methods: Data from 141 patients with moderate‐to‐severe AS followed up for 36 months were analyzed. The end point “outcome” was defined as death of all causes or aortic valve replacement imposed by symptoms or hospital admission for myocardial infarction and/or heart failure. The score was validated in 143 patients prospectively recruited in 2 different centers. Results: The 40 events occurred in the original cohort were associated with higher aortic transvalvular peak jet velocity, calcium score, and observed/predicted left ventricular (LV) mass ratio. Based on the hazard ratios of Cox analysis, the score was calculated as follows: calcium score 1–3 = 1 point, 4 = 6 points; transvalvular peak jet velocity ≤3.6 m/sec = 1 point, 3.6 m/sec = 3 points, observed/predicted LV mass ratio ≤110% = 1 point, >110% = 3 points. After a mean period of 28 ± 18 months, event‐free survival was 18%, 42%, 91%, and 96% in the 4 quartiles of echo score. The accuracy of the score in predicting events was 84% and 77% (P = 0.09) in the original and validation cohort, respectively. Conclusions: The CAIMAN‐ECHO score is a simple and feasible tool useful for an accurate prognostic stratification of patients with asymptomatic moderate‐to‐severe AS.</description><subject>Aged</subject><subject>aortic stenosis</subject><subject>aortic valve disease severity</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - mortality</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>calcium score</subject><subject>Comorbidity</subject><subject>Echocardiography - statistics & numerical data</subject><subject>Female</subject><subject>Heart Failure - diagnostic imaging</subject><subject>Heart Failure - mortality</subject><subject>Heart Valve Prosthesis Implantation - mortality</subject><subject>Heart Valve Prosthesis Implantation - utilization</subject><subject>Humans</subject><subject>inappropriate left ventricular mass</subject><subject>Incidence</subject><subject>Italy - epidemiology</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - mortality</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><subject>Single-Blind Method</subject><subject>Survival Analysis</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0742-2822</issn><issn>1540-8175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kF1P2zAUhq0JNArbzX7AZHGFkML8EdsJdyWUthJrq7XTLi3Hcai3NC52Cuu_n0uAy_niWEd6zmOfF4AvGF3heL4ZvXZXmCDOPoABZilKMizYERggkZKEZIScgNMQfiOEBMbpR3BCKCEip2wAuoV3D60LndVw2XnV2drqWF0Lyz0sXPtk2kOnGjiKz2jlK-sevNqu99DVcBHRCAT4bLs1HDrfe0w02nANV2sDz4vh9PtwloyKyRwutfPm_BM4rlUTzOfX-wz8vButiklyPx9Pi-F9oikXLG6B4iIkx5oInJG8FirVmtD4-QohVWYlMtxUTPCaszQnqcgFY6SsNDd5yRU9Axe9d-vd486ETm5s0KZpVGvcLkhMSUozxjMa0cse1d6F4E0tt95ulN9LjOQhZXlIWb6kHOGvr95duTHVO_oWawRwDzzbxuz_o5KHVN6kST9jQ2f-vs8o_0dyQQWTv2ZjiX7cjic3d1je0n9ZdpU0</recordid><startdate>201304</startdate><enddate>201304</enddate><creator>Cioffi, Giovanni</creator><creator>Mazzone, Carmine</creator><creator>Faggiano, Pompilio</creator><creator>Tarantini, Luigi</creator><creator>Di Lenarda, Andrea</creator><creator>Russo, Tiziano Edoardo</creator><creator>Selmi, Alessandro</creator><creator>Stefenelli, Carlo</creator><creator>Furlanello, Francesco</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201304</creationdate><title>Prognostic Stratification by Conventional Echocardiography of Patients with Aortic Stenosis: The "CAIMAN-ECHO Score"</title><author>Cioffi, Giovanni ; Mazzone, Carmine ; Faggiano, Pompilio ; Tarantini, Luigi ; Di Lenarda, Andrea ; Russo, Tiziano Edoardo ; Selmi, Alessandro ; Stefenelli, Carlo ; Furlanello, Francesco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3675-810817291c271829f7a4cc23322d00ab8b0e6ed576f654924797552bdc6e9b6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>aortic stenosis</topic><topic>aortic valve disease severity</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - mortality</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>calcium score</topic><topic>Comorbidity</topic><topic>Echocardiography - statistics & numerical data</topic><topic>Female</topic><topic>Heart Failure - diagnostic imaging</topic><topic>Heart Failure - mortality</topic><topic>Heart Valve Prosthesis Implantation - mortality</topic><topic>Heart Valve Prosthesis Implantation - utilization</topic><topic>Humans</topic><topic>inappropriate left ventricular mass</topic><topic>Incidence</topic><topic>Italy - epidemiology</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial Infarction - mortality</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><topic>Single-Blind Method</topic><topic>Survival Analysis</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cioffi, Giovanni</creatorcontrib><creatorcontrib>Mazzone, Carmine</creatorcontrib><creatorcontrib>Faggiano, Pompilio</creatorcontrib><creatorcontrib>Tarantini, Luigi</creatorcontrib><creatorcontrib>Di Lenarda, Andrea</creatorcontrib><creatorcontrib>Russo, Tiziano Edoardo</creatorcontrib><creatorcontrib>Selmi, Alessandro</creatorcontrib><creatorcontrib>Stefenelli, Carlo</creatorcontrib><creatorcontrib>Furlanello, Francesco</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cioffi, Giovanni</au><au>Mazzone, Carmine</au><au>Faggiano, Pompilio</au><au>Tarantini, Luigi</au><au>Di Lenarda, Andrea</au><au>Russo, Tiziano Edoardo</au><au>Selmi, Alessandro</au><au>Stefenelli, Carlo</au><au>Furlanello, Francesco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Stratification by Conventional Echocardiography of Patients with Aortic Stenosis: The "CAIMAN-ECHO Score"</atitle><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle><addtitle>Echocardiography</addtitle><date>2013-04</date><risdate>2013</risdate><volume>30</volume><issue>4</issue><spage>367</spage><epage>377</epage><pages>367-377</pages><issn>0742-2822</issn><eissn>1540-8175</eissn><abstract>Background and Aim: Surgery is not recommended in asymptomatic patients with aortic stenosis (AS). However, prognosis of these patients is worse than retained. We built a simple score (named by the acronym “CAIMAN”) for stratifying asymptomatic patients with AS according to the different risk for cardiovascular events. Material and Methods: Data from 141 patients with moderate‐to‐severe AS followed up for 36 months were analyzed. The end point “outcome” was defined as death of all causes or aortic valve replacement imposed by symptoms or hospital admission for myocardial infarction and/or heart failure. The score was validated in 143 patients prospectively recruited in 2 different centers. Results: The 40 events occurred in the original cohort were associated with higher aortic transvalvular peak jet velocity, calcium score, and observed/predicted left ventricular (LV) mass ratio. Based on the hazard ratios of Cox analysis, the score was calculated as follows: calcium score 1–3 = 1 point, 4 = 6 points; transvalvular peak jet velocity ≤3.6 m/sec = 1 point, 3.6 m/sec = 3 points, observed/predicted LV mass ratio ≤110% = 1 point, >110% = 3 points. After a mean period of 28 ± 18 months, event‐free survival was 18%, 42%, 91%, and 96% in the 4 quartiles of echo score. The accuracy of the score in predicting events was 84% and 77% (P = 0.09) in the original and validation cohort, respectively. Conclusions: The CAIMAN‐ECHO score is a simple and feasible tool useful for an accurate prognostic stratification of patients with asymptomatic moderate‐to‐severe AS.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>23227935</pmid><doi>10.1111/echo.12065</doi><tpages>11</tpages></addata></record> |
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| subjects | Aged aortic stenosis aortic valve disease severity Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - mortality Aortic Valve Stenosis - surgery calcium score Comorbidity Echocardiography - statistics & numerical data Female Heart Failure - diagnostic imaging Heart Failure - mortality Heart Valve Prosthesis Implantation - mortality Heart Valve Prosthesis Implantation - utilization Humans inappropriate left ventricular mass Incidence Italy - epidemiology Longitudinal Studies Male Myocardial Infarction - diagnostic imaging Myocardial Infarction - mortality Prognosis Reproducibility of Results Risk Factors Sensitivity and Specificity Severity of Illness Index Single-Blind Method Survival Analysis Survival Rate Treatment Outcome |
| title | Prognostic Stratification by Conventional Echocardiography of Patients with Aortic Stenosis: The "CAIMAN-ECHO Score" |
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