An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area

Background Although indexing effective orifice area (EOA) by body surface area (BSA) is recommended, this method has several disadvantages, since it corrects by acquired fatty tissue. Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. Graphical Abstract Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Gamaza-Chulián, Sergio [verfasserIn] González-Testón, Fátima Díaz-Retamino, Enrique Zafra-Cobo, Francisco M. González-Caballero, Eva

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Aortic stenosis Aortic valve area Echocardiography Prognosis

Anmerkung:	© The Author(s) 2023

Übergeordnetes Werk:	Enthalten in: Cardiovascular ultrasound - London : Biomed Central, 2003, 21(2023), 1 vom: 22. Aug.
Übergeordnetes Werk:	volume:21 ; year:2023 ; number:1 ; day:22 ; month:08

Links:	Volltext

DOI / URN:	10.1186/s12947-023-00314-8

Katalog-ID:	SPR052818578

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245	1	3	\|a An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area
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520			\|a Background Although indexing effective orifice area (EOA) by body surface area (BSA) is recommended, this method has several disadvantages, since it corrects by acquired fatty tissue. Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. Graphical Abstract
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allfields	10.1186/s12947-023-00314-8 doi (DE-627)SPR052818578 (SPR)s12947-023-00314-8-e DE-627 ger DE-627 rakwb eng Gamaza-Chulián, Sergio verfasserin aut An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Although indexing effective orifice area (EOA) by body surface area (BSA) is recommended, this method has several disadvantages, since it corrects by acquired fatty tissue. Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. Graphical Abstract Aortic stenosis (dpeaa)DE-He213 Aortic valve area (dpeaa)DE-He213 Echocardiography (dpeaa)DE-He213 Prognosis (dpeaa)DE-He213 González-Testón, Fátima aut Díaz-Retamino, Enrique aut Zafra-Cobo, Francisco M. aut González-Caballero, Eva aut Enthalten in Cardiovascular ultrasound London : Biomed Central, 2003 21(2023), 1 vom: 22. Aug. (DE-627)363752625 (DE-600)2105610-9 1476-7120 nnns volume:21 year:2023 number:1 day:22 month:08 https://dx.doi.org/10.1186/s12947-023-00314-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2023 1 22 08
spelling	10.1186/s12947-023-00314-8 doi (DE-627)SPR052818578 (SPR)s12947-023-00314-8-e DE-627 ger DE-627 rakwb eng Gamaza-Chulián, Sergio verfasserin aut An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Although indexing effective orifice area (EOA) by body surface area (BSA) is recommended, this method has several disadvantages, since it corrects by acquired fatty tissue. Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. Graphical Abstract Aortic stenosis (dpeaa)DE-He213 Aortic valve area (dpeaa)DE-He213 Echocardiography (dpeaa)DE-He213 Prognosis (dpeaa)DE-He213 González-Testón, Fátima aut Díaz-Retamino, Enrique aut Zafra-Cobo, Francisco M. aut González-Caballero, Eva aut Enthalten in Cardiovascular ultrasound London : Biomed Central, 2003 21(2023), 1 vom: 22. Aug. (DE-627)363752625 (DE-600)2105610-9 1476-7120 nnns volume:21 year:2023 number:1 day:22 month:08 https://dx.doi.org/10.1186/s12947-023-00314-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2023 1 22 08
allfields_unstemmed	10.1186/s12947-023-00314-8 doi (DE-627)SPR052818578 (SPR)s12947-023-00314-8-e DE-627 ger DE-627 rakwb eng Gamaza-Chulián, Sergio verfasserin aut An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Although indexing effective orifice area (EOA) by body surface area (BSA) is recommended, this method has several disadvantages, since it corrects by acquired fatty tissue. Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. Graphical Abstract Aortic stenosis (dpeaa)DE-He213 Aortic valve area (dpeaa)DE-He213 Echocardiography (dpeaa)DE-He213 Prognosis (dpeaa)DE-He213 González-Testón, Fátima aut Díaz-Retamino, Enrique aut Zafra-Cobo, Francisco M. aut González-Caballero, Eva aut Enthalten in Cardiovascular ultrasound London : Biomed Central, 2003 21(2023), 1 vom: 22. Aug. (DE-627)363752625 (DE-600)2105610-9 1476-7120 nnns volume:21 year:2023 number:1 day:22 month:08 https://dx.doi.org/10.1186/s12947-023-00314-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2023 1 22 08
allfieldsGer	10.1186/s12947-023-00314-8 doi (DE-627)SPR052818578 (SPR)s12947-023-00314-8-e DE-627 ger DE-627 rakwb eng Gamaza-Chulián, Sergio verfasserin aut An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Although indexing effective orifice area (EOA) by body surface area (BSA) is recommended, this method has several disadvantages, since it corrects by acquired fatty tissue. Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. Graphical Abstract Aortic stenosis (dpeaa)DE-He213 Aortic valve area (dpeaa)DE-He213 Echocardiography (dpeaa)DE-He213 Prognosis (dpeaa)DE-He213 González-Testón, Fátima aut Díaz-Retamino, Enrique aut Zafra-Cobo, Francisco M. aut González-Caballero, Eva aut Enthalten in Cardiovascular ultrasound London : Biomed Central, 2003 21(2023), 1 vom: 22. Aug. (DE-627)363752625 (DE-600)2105610-9 1476-7120 nnns volume:21 year:2023 number:1 day:22 month:08 https://dx.doi.org/10.1186/s12947-023-00314-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2023 1 22 08
allfieldsSound	10.1186/s12947-023-00314-8 doi (DE-627)SPR052818578 (SPR)s12947-023-00314-8-e DE-627 ger DE-627 rakwb eng Gamaza-Chulián, Sergio verfasserin aut An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Although indexing effective orifice area (EOA) by body surface area (BSA) is recommended, this method has several disadvantages, since it corrects by acquired fatty tissue. Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. Graphical Abstract Aortic stenosis (dpeaa)DE-He213 Aortic valve area (dpeaa)DE-He213 Echocardiography (dpeaa)DE-He213 Prognosis (dpeaa)DE-He213 González-Testón, Fátima aut Díaz-Retamino, Enrique aut Zafra-Cobo, Francisco M. aut González-Caballero, Eva aut Enthalten in Cardiovascular ultrasound London : Biomed Central, 2003 21(2023), 1 vom: 22. Aug. (DE-627)363752625 (DE-600)2105610-9 1476-7120 nnns volume:21 year:2023 number:1 day:22 month:08 https://dx.doi.org/10.1186/s12947-023-00314-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2023 1 22 08
language	English
source	Enthalten in Cardiovascular ultrasound 21(2023), 1 vom: 22. Aug. volume:21 year:2023 number:1 day:22 month:08
sourceStr	Enthalten in Cardiovascular ultrasound 21(2023), 1 vom: 22. Aug. volume:21 year:2023 number:1 day:22 month:08
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Aortic stenosis Aortic valve area Echocardiography Prognosis
isfreeaccess_bool	true
container_title	Cardiovascular ultrasound
authorswithroles_txt_mv	Gamaza-Chulián, Sergio @@aut@@ González-Testón, Fátima @@aut@@ Díaz-Retamino, Enrique @@aut@@ Zafra-Cobo, Francisco M. @@aut@@ González-Caballero, Eva @@aut@@
publishDateDaySort_date	2023-08-22T00:00:00Z
hierarchy_top_id	363752625
id	SPR052818578
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR052818578</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20231119064836.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230822s2023 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s12947-023-00314-8</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR052818578</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s12947-023-00314-8-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Gamaza-Chulián, Sergio</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="3"><subfield code="a">An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Author(s) 2023</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Although indexing effective orifice area (EOA) by body surface area (BSA) is recommended, this method has several disadvantages, since it corrects by acquired fatty tissue. Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. 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author	Gamaza-Chulián, Sergio
spellingShingle	Gamaza-Chulián, Sergio misc Aortic stenosis misc Aortic valve area misc Echocardiography misc Prognosis An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area
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topic_title	An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area Aortic stenosis (dpeaa)DE-He213 Aortic valve area (dpeaa)DE-He213 Echocardiography (dpeaa)DE-He213 Prognosis (dpeaa)DE-He213
topic	misc Aortic stenosis misc Aortic valve area misc Echocardiography misc Prognosis
topic_unstemmed	misc Aortic stenosis misc Aortic valve area misc Echocardiography misc Prognosis
topic_browse	misc Aortic stenosis misc Aortic valve area misc Echocardiography misc Prognosis
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title	An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area
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title_full	An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area
author_sort	Gamaza-Chulián, Sergio
journal	Cardiovascular ultrasound
journalStr	Cardiovascular ultrasound
lang_code	eng
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author_browse	Gamaza-Chulián, Sergio González-Testón, Fátima Díaz-Retamino, Enrique Zafra-Cobo, Francisco M. González-Caballero, Eva
container_volume	21
format_se	Elektronische Aufsätze
author-letter	Gamaza-Chulián, Sergio
doi_str_mv	10.1186/s12947-023-00314-8
title_sort	alternative method of indexation in aortic stenosis: height-adjusted effective orifice area
title_auth	An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area
abstract	Background Although indexing effective orifice area (EOA) by body surface area (BSA) is recommended, this method has several disadvantages, since it corrects by acquired fatty tissue. Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. Graphical Abstract © The Author(s) 2023
abstractGer	Background Although indexing effective orifice area (EOA) by body surface area (BSA) is recommended, this method has several disadvantages, since it corrects by acquired fatty tissue. Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. Graphical Abstract © The Author(s) 2023
abstract_unstemmed	Background Although indexing effective orifice area (EOA) by body surface area (BSA) is recommended, this method has several disadvantages, since it corrects by acquired fatty tissue. Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. Graphical Abstract © The Author(s) 2023
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title_short	An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area
url	https://dx.doi.org/10.1186/s12947-023-00314-8
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author2	González-Testón, Fátima Díaz-Retamino, Enrique Zafra-Cobo, Francisco M. González-Caballero, Eva
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doi_str	10.1186/s12947-023-00314-8
up_date	2024-07-03T15:00:04.903Z
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Our aim was to analyze the value of EOA normalized by height for predicting cardiovascular outcome in patients with aortic stenosis (AS). Methods Patients with AS (peak velocity > 2 m/s) evaluated in our echocardiography laboratory between January 2015 and June 2018 were prospectively enrolled. EOA was indexed by BSA and height. A composite primary endpoint was defined as cardiac death or aortic valve replacement. A receiver operating characteristic curve was plotted to determine the best cutoff value of EOA/height for predicting cardiovascular events. Results Four-hundred and fifteen patients were included (52% women, mean age 74.8 ± 11.6 years). Area under the curve was similar for EOA/BSA (AUC 0.75, p < 0.001) and EOA/height (AUC 0.75, p < 0.001). A cutoff value of 0.60 $ cm^{2} $/m for EOA/height had a sensitivity of 84%, specificity of 61%, positive predictive value of 60% and negative predictive value of 84%. One-year survival from primary endpoint was significantly lower in patients with EOA/height ≤ 0.60 $ cm^{2} $/m (48 ± 5% vs 91 ± 4%, log-rank p < 0.001) than EOA/height > 0.60 $ cm^{2} $/m. The excess of risk of cardiovascular events seen in univariate analysis persists even after adjustment for other demonstrated adverse prognostic variables (HR 5.91, 95% CI 3.21–10.88, p < 0.001). In obese patients, there was an excess of risk in patients with EOA/height < 0.60 cm2/m (HR 10.2, 95% CI 3.5–29.5, p < 0.001), but not in EOA/BSA < 0.60 $ cm^{2} $/$ m^{2} $ (HR 0.14, 95% CI 0.14–1.4, p = 0.23). Conclusions We could identify a subgroup of patients with AS at high risk of cardiovascular events. Consequently, we recommend using EOA/height as a method of indexation in AS, especially in obese patients, with a cutoff of 0.60 cm2/m for identifying patients with higher cardiovascular risk. 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An alternative method of indexation in aortic stenosis: height-adjusted effective orifice area

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