Does left atrial size predict mortality in asymptomatic patients with severe aortic stenosis

Grace Casaclang-Verzosa, Joseph F. Malouf, Christopher G. Scott, Eldyn Marcony Juracan, Rick A. Nishimura, Patricia Pellikka

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: We assessed the hypothesis that diastolic function represented by left atrial size determines the rate of development of symptoms and the risk of all-cause mortality in asymptomatic patients with severe aortic stenosis (AS). Methods: From a database of 622 asymptomatic patients with isolated severe AS (velocity by Doppler ≥ 4 msec) followed for 5.4 ± 4 years, we reviewed the echocardiograms and evaluated Doppler echocardiographic indices of diastolic function. Prediction of symptom development and mortality by left atrial diameter with and without adjusting for clinical and echocardiographic parameters was performed using Cox proportional-hazards regression analysis. Results: The age was 71 ± 11 years and 317 (62%) patients were males. The aortic valve mean gradient was 46 ± 11 mmHg, and the Doppler-derived aortic valve area was 0.9 ± 0.2 cm2. During follow-up, symptoms developed in 233 (45%), valve surgery was performed in 290 (57%) and 138 (27%) died. Left atrial enlargement was significantly correlated with symptom development (P < 0.05) but the association diminished after adjusting for aortic valve area and peak velocity (P = 0.2). However, atrial diameter predicted death independent of age and gender (P = 0.007), comorbid conditions (P = 0.03), and AS severity and Doppler parameters of diastolic function (P = 0.002). Conclusion: Diastolic function, represented as left atrial diameter, is related to mortality in asymptomatic patients with severe AS.

Original languageEnglish (US)
Pages (from-to)105-109
Number of pages5
JournalEchocardiography
Volume27
Issue number2
DOIs
StatePublished - Feb 2010

Fingerprint

Aortic Valve Stenosis
Aortic Valve
Mortality
Left Atrial Function
Regression Analysis
Databases

Keywords

  • Aortic stenosis
  • Echocardiography
  • Left atrium
  • Valvular heart disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Does left atrial size predict mortality in asymptomatic patients with severe aortic stenosis. / Casaclang-Verzosa, Grace; Malouf, Joseph F.; Scott, Christopher G.; Juracan, Eldyn Marcony; Nishimura, Rick A.; Pellikka, Patricia.

In: Echocardiography, Vol. 27, No. 2, 02.2010, p. 105-109.

Research output: Contribution to journalArticle

Casaclang-Verzosa, Grace ; Malouf, Joseph F. ; Scott, Christopher G. ; Juracan, Eldyn Marcony ; Nishimura, Rick A. ; Pellikka, Patricia. / Does left atrial size predict mortality in asymptomatic patients with severe aortic stenosis. In: Echocardiography. 2010 ; Vol. 27, No. 2. pp. 105-109.
@article{4ff94e7a7e35456e82dde5021c49ecb8,
title = "Does left atrial size predict mortality in asymptomatic patients with severe aortic stenosis",
abstract = "Background: We assessed the hypothesis that diastolic function represented by left atrial size determines the rate of development of symptoms and the risk of all-cause mortality in asymptomatic patients with severe aortic stenosis (AS). Methods: From a database of 622 asymptomatic patients with isolated severe AS (velocity by Doppler ≥ 4 msec) followed for 5.4 ± 4 years, we reviewed the echocardiograms and evaluated Doppler echocardiographic indices of diastolic function. Prediction of symptom development and mortality by left atrial diameter with and without adjusting for clinical and echocardiographic parameters was performed using Cox proportional-hazards regression analysis. Results: The age was 71 ± 11 years and 317 (62{\%}) patients were males. The aortic valve mean gradient was 46 ± 11 mmHg, and the Doppler-derived aortic valve area was 0.9 ± 0.2 cm2. During follow-up, symptoms developed in 233 (45{\%}), valve surgery was performed in 290 (57{\%}) and 138 (27{\%}) died. Left atrial enlargement was significantly correlated with symptom development (P < 0.05) but the association diminished after adjusting for aortic valve area and peak velocity (P = 0.2). However, atrial diameter predicted death independent of age and gender (P = 0.007), comorbid conditions (P = 0.03), and AS severity and Doppler parameters of diastolic function (P = 0.002). Conclusion: Diastolic function, represented as left atrial diameter, is related to mortality in asymptomatic patients with severe AS.",
keywords = "Aortic stenosis, Echocardiography, Left atrium, Valvular heart disease",
author = "Grace Casaclang-Verzosa and Malouf, {Joseph F.} and Scott, {Christopher G.} and Juracan, {Eldyn Marcony} and Nishimura, {Rick A.} and Patricia Pellikka",
year = "2010",
month = "2",
doi = "10.1111/j.1540-8175.2009.01002.x",
language = "English (US)",
volume = "27",
pages = "105--109",
journal = "Echocardiography",
issn = "0742-2822",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Does left atrial size predict mortality in asymptomatic patients with severe aortic stenosis

AU - Casaclang-Verzosa, Grace

AU - Malouf, Joseph F.

AU - Scott, Christopher G.

AU - Juracan, Eldyn Marcony

AU - Nishimura, Rick A.

AU - Pellikka, Patricia

PY - 2010/2

Y1 - 2010/2

N2 - Background: We assessed the hypothesis that diastolic function represented by left atrial size determines the rate of development of symptoms and the risk of all-cause mortality in asymptomatic patients with severe aortic stenosis (AS). Methods: From a database of 622 asymptomatic patients with isolated severe AS (velocity by Doppler ≥ 4 msec) followed for 5.4 ± 4 years, we reviewed the echocardiograms and evaluated Doppler echocardiographic indices of diastolic function. Prediction of symptom development and mortality by left atrial diameter with and without adjusting for clinical and echocardiographic parameters was performed using Cox proportional-hazards regression analysis. Results: The age was 71 ± 11 years and 317 (62%) patients were males. The aortic valve mean gradient was 46 ± 11 mmHg, and the Doppler-derived aortic valve area was 0.9 ± 0.2 cm2. During follow-up, symptoms developed in 233 (45%), valve surgery was performed in 290 (57%) and 138 (27%) died. Left atrial enlargement was significantly correlated with symptom development (P < 0.05) but the association diminished after adjusting for aortic valve area and peak velocity (P = 0.2). However, atrial diameter predicted death independent of age and gender (P = 0.007), comorbid conditions (P = 0.03), and AS severity and Doppler parameters of diastolic function (P = 0.002). Conclusion: Diastolic function, represented as left atrial diameter, is related to mortality in asymptomatic patients with severe AS.

AB - Background: We assessed the hypothesis that diastolic function represented by left atrial size determines the rate of development of symptoms and the risk of all-cause mortality in asymptomatic patients with severe aortic stenosis (AS). Methods: From a database of 622 asymptomatic patients with isolated severe AS (velocity by Doppler ≥ 4 msec) followed for 5.4 ± 4 years, we reviewed the echocardiograms and evaluated Doppler echocardiographic indices of diastolic function. Prediction of symptom development and mortality by left atrial diameter with and without adjusting for clinical and echocardiographic parameters was performed using Cox proportional-hazards regression analysis. Results: The age was 71 ± 11 years and 317 (62%) patients were males. The aortic valve mean gradient was 46 ± 11 mmHg, and the Doppler-derived aortic valve area was 0.9 ± 0.2 cm2. During follow-up, symptoms developed in 233 (45%), valve surgery was performed in 290 (57%) and 138 (27%) died. Left atrial enlargement was significantly correlated with symptom development (P < 0.05) but the association diminished after adjusting for aortic valve area and peak velocity (P = 0.2). However, atrial diameter predicted death independent of age and gender (P = 0.007), comorbid conditions (P = 0.03), and AS severity and Doppler parameters of diastolic function (P = 0.002). Conclusion: Diastolic function, represented as left atrial diameter, is related to mortality in asymptomatic patients with severe AS.

KW - Aortic stenosis

KW - Echocardiography

KW - Left atrium

KW - Valvular heart disease

UR - http://www.scopus.com/inward/record.url?scp=77649208137&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77649208137&partnerID=8YFLogxK

U2 - 10.1111/j.1540-8175.2009.01002.x

DO - 10.1111/j.1540-8175.2009.01002.x

M3 - Article

C2 - 20113330

AN - SCOPUS:77649208137

VL - 27

SP - 105

EP - 109

JO - Echocardiography

JF - Echocardiography

SN - 0742-2822

IS - 2

ER -