Valvular & structural heart disease
A Novel Echocardiographic Parameter to Confirm Low-Gradient Aortic Stenosis Severity
Authors' conclusion
MG/EOA ratio can be useful in low-flow, LG-AS to confirm AS severity and may complement DSE or aortic valve calcium scoring.
Study context
- Population
- Patients with low-flow, low-gradient aortic stenosis (AS) (TOPAS study) and an in vitro circulatory modelplus 93 in vitro conditions
- Participants
- 188 patients
- Outcome
- Diagnostic accuracy of MG/EOA ratio to identify true-severe AS
Methodological detailsretrospective, in vitro and in vivo data sets
- Retrospective
- In vitro and in vivo data sets
Performance
As reported in the abstract
Identification of true-severe AS
| Test or model | Correct classification (in vivo) | Correct classification (in vitro) |
|---|---|---|
| MG/EOA ≥25 mm Hg/cm² | 85% | 100% |
MG/EOA ≥25 mm Hg/cm²
Correct classification (in vivo)85%
Correct classification (in vitro)100%
- Optimal MG/EOA cutoff
- ≥25 mm Hg/cm²
Further findings
Composite of AV replacement or all-cause mortality · median follow-up 1.41 ± 0.75 years
| Comparison | Adjusted HR (95% CI) | P value | |
|---|---|---|---|
| MG/EOA ≥25 mm Hg/cm² | 2.36 (1.63–3.42) | P < 0.001 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
- Composite of AV replacement or all-cause mortality — Patients meeting composite endpoint
- 146 (78%)
- Composite of AV replacement or all-cause mortality — Harrell's C-index of MG/EOA
- 0.68
- Composite of AV replacement or all-cause mortality — C-index of projected EOA by dobutamine stress echocardiography (DSE)
- 0.67
Original publication
A Novel Echocardiographic Parameter to Confirm Low-Gradient Aortic Stenosis Severity. JACC Adv. Published 6 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it