Cohort study
mPAP/CO Slope and Oxygen Uptake Add Prognostic Value in Aortic Stenosis
- Prospective cohort study
- external validation cohort
Authors' conclusion
In moderate and severe aortic valve stenosis, mPAP/CO slope and percent-predicted peak Vo2 were independent predictors of cardiovascular events, whereas peak systolic pulmonary artery pressure was not. In addition to aortic valve area and indexed left atrial volume, percent-predicted peak Vo2 and mPAP/CO slope cumulatively improved risk stratification.
Study context
- Population
- Moderate and severe AS (aortic valve area ≤1.5 cm²) undergoing cardiopulmonary exercise testing with echocardiography
- Participants
- 143 vs 141
- Exposure
- Derivation vs Validation
- Derivationn = 143
- Validationn = 141
- Outcome
- CV events:
- CV death
- HF hospitalization
- New-onset AF
- Aortic valve replacement
- Follow-up
- 1 year
Main finding
As reported in the abstract
Independent predictors of CV events
- Peak aortic velocity, OR per SD
- 1.48; P=0.036
- Indexed left atrial volume, OR per SD
- 2.15; P=0.001
- E/e' at rest, OR per SD
- 1.61; P=0.012
- mPAP/CO slope, OR per SD
- 2.01; P=0.002
- Percent-predicted peak oxygen uptake, OR per SD
- 0.59; P=0.007
- Peak systolic pulmonary artery pressure (not independently associated), OR per SD
- 1.28; P=0.219
Observational data: associations, not effects.
Further findings
| Outcome | Derivation | Validation |
|---|---|---|
| CV events by type · 1 year | ||
| CV death | 1 | 5 |
| Aortic valve replacement | 32 | 32 |
| New-onset AF | 9 | 1 |
| HF hospitalization | 4 | 10 |
Incremental prognostic value of peak Vo2 (percent) and mPAP/CO slope over indexed left atrial volume and aortic valve area
- Incremental prognostic value
- P < 0.001
Original publication
mPAP/CO Slope and Oxygen Uptake Add Prognostic Value in Aortic Stenosis. Circulation. Published 27 February 2024. doi:10.1161/circulationaha.123.067130
Summarised from the published abstract; every number is checked against it