Combined Value of Dimensionless Index and Transvalvular Flow Rate in Risk Stratification of Aortic Stenosis

Mayooran Namasivayam, Timothy W. Churchill, Romain Capoulade, Philippe Pibarot, Jacqueline S. Danik, Michael H. Picard, Robert A. Levine, Judy Hung

Research output: Contribution to journalArticlepeer-review

Abstract

Aortic stenosis (AS) is difficult to phenotype. The metrics of severity are frequently discordant, making prognostication challenging. Flow state is central to accurately determining severity. We sought to evaluate the prognostic value of dimensionless index (DI) and transvalvular flow rate (Q) in AS. We evaluated 2 independent, longitudinal registries of ≥ moderate severity AS (aortic valve area ≤1.5 cm2 or mean gradient ≥20 mm Hg) with complete data follow-up. In the primary cohort (n = 1,104, 77 ± 11 years, 40% female), the DI and Q category significantly predicted mortality (p <0.001) (Figure 1), with the highest risk being low DI and low Q (DI <0.25, Q ≤210 mL/s). In the validation cohort (n = 939, 70 ± 13 years, 42% female), similar results were seen in Kaplan–Meier (p <0.001) and multivariable Cox model analyses (p <0.01). We advocate for wider combined use of DI and Q in AS assessment to augment current diagnostic and prognostic approaches.

Original languageEnglish
Pages (from-to)69-71
Number of pages3
JournalAmerican Journal of Cardiology
Volume213
DOIs
StatePublished - 15 Feb 2024
Externally publishedYes

Keywords

  • aortic stenosis
  • diagnosis
  • dimensionless index
  • echocardiography
  • flow rate
  • low flow
  • low gradient

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