Table 1 Baseline characteristics and echocardiographic parameters.

From: Asymptomatic versus Symptomatic Patients with Severe Aortic Stenosis

 

Symptomatic patients

(N = 1215)

Asymptomatic patients

(N = 1808)

P value

Clinical characteristics

Age, years*

76.4 ± 9.8

76.8 ± 9.6

0.27

Age ≥ 80 years

484 (40%)

749 (41%)

0.39

Male*

469 (39%)

730 (40%)

0.34

BMI, kg/m²

22.0 ± 3.8

22.0 ± 3.8

0.71

BMI < 22 kg/m²*

698 (57%)

1057 (59%)

0.60

BSA, m²

1.47 ± 0.19

1.47 ± 0.18

0.96

Hypertension*

853 (70%)

1248 (69%)

0.49

Current smoking*

66 (5.4%)

95 (5.3%)

0.87

History of smoking

274 (23%)

402 (22%)

0.86

Dyslipidemia

464 (38%)

648 (36%)

0.19

  On statin therapy

345 (28%)

464 (26%)

0.10

Diabetes mellitus

269 (22%)

434 (24%)

0.24

  On insulin therapy*

63 (5.2%)

91 (5.0%)

0.87

Coronary artery disease*

406 (33%)

488 (27%)

<0.001

Prior myocardial infarction*

83 (6.8%)

151 (8.4%)

0.13

Prior PCI

128 (11%)

286 (16%)

<0.001

Prior CABG

70 (5.8%)

98 (5.4%)

0.69

Prior open heart surgery

101 (8.3%)

165 (9.1%)

0.47

Prior symptomatic stroke*

140 (12%)

253 (14%)

0.05

Atrial fibrillation or flutter

271 (22%)

338 (19%)

0.02

Aortic/peripheral vascular disease*

167 (14%)

299 (17%)

0.04

Serum creatinine, mg/dl*

0.87 (0.69–1.22)

0.84 (0.69–1.15)

0.35

Creatinine level > 2 mg/dl

184 (15%)

249 (14%)

0.29

Hemodialysis*

138 (11%)

207 (11%)

0.95

Anemia*

676 (56%)

862 (48%)

<0.001

Liver cirrhosis (Child-Pugh B or C)*

18 (1.5%)

11 (0.6%)

0.02

Malignancy

146 (12%)

276 (15%)

0.01

  Malignancy currently under treatment*

33 (2.7%)

94 (5.2%)

0.001

Chest wall irradiation

10 (0.8%)

12 (0.7%)

0.67

Immunosuppressive therapy

34 (2.8%)

60 (3.3%)

0.46

Chronic lung disease (moderate or severe)*

39 (3.2%)

43 (2.4%)

0.17

Logistic EuroSCORE, %

8.6 (5.5–14.4)

8.4 (5.1–13.9)

0.08

EuroSCORE II,%

2.7 (1.5–4.1)

2.4 (1.4–3.6)

<0.001

STS score (PROM), %

3.4 (2.1–5.3)

3.3 (2.0–5.2)

0.23

Etiology of aortic stenosis

  

0.33

Degenerative

1058 (87%)

1584 (88%)

 

Congenital (unicuspid, bicuspid, or quadricuspid)

95 (7.8%)

136 (7.5%)

 

Rheumatic

54 (4.4%)

66 (3.7%)

 

Infective endocarditis

0 (0%)

4 (0.2%)

 

Other

8 (0.7%)

18 (1.0%)

 

Types of symptoms

Exertional dyspnea

813

  

  Syncope

163

  

  Angina

405

  

Initial treatment strategy

  

<0.001

Initial AVR*

635 (52%)

291 (16%)

 

Conservative

580 (48%)

1517 (84%)

 

Echocardiographic variables

Vmax, m/s

4.4 ± 0.9

3.9 ± 0.8

<0.001

Vmax ≥ 5 m/s

316 (26.0)

207 (11.5)

<0.001

Peak aortic PG, mmHg

81 ± 32

65 ± 28

<0.001

Mean aortic PG, mmHg

47 ± 21

36 ± 17

<0.001

Mean aortic PG ≥ 60 mmHg

253 (26%)

140 (9.4%)

<0.001

AVA (equation of continuity), cm²

0.68 ± 0.18

0.77 ± 0.17

<0.001

AVA index, cm²/m²

0.47 ± 0.13

0.53 ± 0.12

<0.001

AVA ≤ 0.6 cm2

416 (37%)

335 (20%)

<0.001

Eligibility for severe AS

  Vmax > 4 m/s*

851 (70%)

861 (48%)

<0.001

  Mean aortic pressure gradient > 40 mmHg

573 (59%)

537 (36%)

<0.001

  Vmax > 4 m/s or mean aortic PG > 40 mmHg

856 (71%)

869 (48%)

<0.001

  AVA < 1.0 cm2 alone with LVEF < 50%

83 (6.8%)

111 (6.1%)

0.45

  AVA < 1.0 cm2 alone with LVEF ≥ 50%

276 (23%)

828 (46%)

<0.001

LV end-diastolic diameter, mm

46.4 ± 7.1

44.8 ± 6.0

<0.001

LV end-systolic diameter, mm

30.3 ± 8.0

28.4 ± 6.2

<0.001

LVEF, %

63.4 ± 13.3

65.9 ± 10.9

<0.001

LVEF < 40%

83 (6.8%)

57 (3.2%)

<0.001

LVEF < 50%

172 (14%)

142 (7%)

<0.001

IVST in diastole

11.6 ± 2.3

11.1 ± 2.2

<0.001

PWT in diastole

11.2 ± 2.0

10.7 ± 2.0

<0.001

Any combined valvular disease (moderate or severe)*

522 (43%)

560 (31%)

<0.001

  Moderate or severe AR

281 (23%)

293 (16%)

<0.001

  Moderate or severe MS

54 (4.4%)

49 (2.7%)

0.01

  Moderate or severe MR

250 (21%)

213 (12%)

<0.001

  Moderate or severe TR

196 (16%)

216 (12%)

<0.001

  TR pressure gradient ≥ 40 mm Hg

204 (17%)

173 (9.6%)

<0.001

  1. Categorical variables were presented as number (percentage). Continuous variables were presented as mean ± SD, or median (interquartile range).
  2. Anemia was defined as hemoglobin <12.0 g/dl in women and <13.0 g/dl in men.
  3. Coronary artery disease included prior myocardial infarction, prior PCI, prior CABG, or documented coronary artery disease at baseline.
  4. *Indicated the covariates incorporated in the multivariable Cox’s proportional hazard models as the risk-adjusting variables.
  5. AR = aortic regurgitation; AS = aortic stenosis; AVA = aortic valve area; AVR = aortic valve replacement; BMI = body mass index; BSA = body surface area; CABG = coronary artery bypass grafting; IVST = interventricular septum thickness; LV = left ventricular; LVEF = left ventricular ejection fraction; MR = mitral regurgitation; MS = mitral stenosis; PCI = percutaneous coronary intervention; PG = pressure gradient; PROM = predicted risk of mortality; PWT = posterior wall thickness; STS = Society of Thoracic Surgeons; TR = tricuspid regurgitation; Vmax = peak aortic jet velocity.
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