Valvular & structural heart disease
A novel staging system of cardiac damage in aortic stenosis based on multi-chamber myocardial deformation
Authors' conclusion
Our staging system for detecting cardiac damage, incorporating multi-chamber myocardial deformation, exhibits a stronger association with outcomes than previously validated systems.
Study context
- Population
- Patients with at least moderate aortic stenosis (AS) (aortic valve area < 1.5 cm²)two cohorts · derivation (median age: 82 years; 51% men) 654 · validation (median age: 77 years; 55% men) 237
- Comparison
- New staging classification vs staging systems proposed by Généreux et al. and Tastet et al. for 2-year all-cause death
- Outcome
- Optimal cut-off values linked to outcomes (ROC curve analysis)
Methodological detailsreanalysis of 2D, Doppler, and speckle tracking echocardiography (STE) data
- Reanalysis of 2D, Doppler, and STE data
Performance
As reported in the abstract
Left ventricular global longitudinal strain (LVGLS)
15%
Peak atrial longitudinal strain (PALS)
13%
Right ventricular free-wall strain (RVFWS)
19%
Further findings
| Outcome | Adjusted-hazard ratio (95% CI) | P value | |
|---|---|---|---|
| All-cause death, new staging scheme (multivariable Cox regression)Per stage; increased risk · multivariable Cox regression | 1.28 (1.10–1.48) | P = 0.001 | |
| 0.512Adjusted-hazard ratio (log scale) |
AUC
| Outcome | New staging classification | Généreux et al. | Tastet et al. | P value |
|---|---|---|---|---|
| Predictive power for 2-year all-cause death · 2 yearsNew staging classification vs Généreux et al. · higher with new staging · similar findings in the validation cohort | 0.67 (95% CI 0.62–0.73) | 0.62 (95% CI 0.56–0.67) | 0.64 (95% CI 0.58–0.70) | P = 0.002 |
| Predictive power for 2-year all-cause death · 2 yearsNew staging classification vs Tastet et al. · higher with new staging · similar findings in the validation cohort | P = 0.041 |
Original publication
A novel staging system of cardiac damage in aortic stenosis based on multi-chamber myocardial deformation. Eur Heart J Cardiovasc Imaging. Published 28 January 2025. doi:10.
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