Table 5.
Demographic, clinical, and echocardiographic characteristics of patients with severe AS
| Characteristic | Severe AS | ||||
|---|---|---|---|---|---|
| Total (n = 551) | Conservative (n = 310) | SAVR (n = 146) | TAVR (n = 95) | P-value | |
| Clinical characteristic | |||||
| Age (yr) | 76.9 ± 10.2 | 79.2 ± 9.9 | 69.4 ± 9.2 | 80.9 ± 5.5 | 0.073 |
| Male sex | 284 (51.5) | 166 (53.5) | 66 (45.2) | 52 (54.7) | 0.723 |
| Body mass index (kg/m2) | 23.6 ± 3.6 | 23.3 ± 3.9 | 24.0 ± 3.1 | 23.8 ± 3.4 | 0.144 |
| NYHA class ≥ II | 384 (69.7) | 188 (60.6) | 112 (76.7) | 84 (88.4) | < 0.001* |
| Hypertension | 361 (65.5) | 204 (66.0) | 84 (57.5) | 73 (76.8) | 0.374 |
| Diabetes | 161 (29.2) | 83 (26.8) | 44 (30.1) | 34 (35.8) | 0.315 |
| Dyslipidemia | 180 (32.7) | 95 (30.6) | 47 (32.2) | 38 (40.0) | 0.198 |
| Atrial fibrillation | 80 (14.5) | 47 (15.2) | 20 (13.7) | 13 (13.7) | 0.650 |
| Chronic dialysis | 19 (3.5) | 9 (2.9) | 4 (2.7) | 6 (6.3) | 0.459 |
| Chronic pulmonary disease | 51 (9.3) | 29 (9.4) | 15 (10.3) | 7 (7.4) | 0.070 |
| Previous MI | 39 (7.1) | 27 (8.7) | 8 (5.5) | 4 (4.2) | 0.518 |
| Hemoglobin (g/dL) | 11.8 ± 2.0 | 11.6 ± 2.1 | 12.5 ± 1.9 | 11.3 ± 1.7 | 0.864 |
| Creatinine (mg/dL) | 1.2 ± 1.1 | 1.2 ± 1.1 | 1.2 ± 1.1 | 1.3 ± 1.3 | 0.729 |
| Creatinine clearance (mL/min) | 66.7 ± 26.7 | 65.9 ± 29.3 | 72.6 ± 22.6 | 61.8 ± 23.1 | 0.709 |
| NT-proBNP (pg/mL) | 6,592 ± 10,766 | 7,537 ± 11,281 | 4,404 ± 7,503 | 6,023 ± 8,687 | 0.185 |
| Echocardiographic characteristic | |||||
| LVEDD (mm) | 49.1 ± 7.3 | 48.1 ± 7.0 | 50.9 ± 7.5 | 48.8 ± 7.2 | 0.061 |
| LVESD (mm) | 32.5 ± 8.5 | 31.8 ± 8.3 | 33.9 ± 8.6 | 31.9 ± 8.6 | 0.396 |
| LVEF (%) | 58.3 ± 12.7 | 58.5 ± 12.7 | 57.8 ± 13.2 | 58.4 ± 12.3 | 0.804 |
| ≤ 50 | 113 (20.5) | 59 (19.0) | 35 (24.0) | 19 (20.2) | 0.474 |
| LV mass index (g/m2) | 131.4 ± 40.9 | 127.3 ± 40.5 | 137.2 ± 40.1 | 135.3 ± 42.1 | 0.008* |
| TR Vmax (m/sec) | 2.8 ± 0.5 | 2.8 ± 0.5 | 2.7 ± 0.5 | 2.8 ± 0.5 | 0.513 |
| LA volume index (mL/m2) | 54.3 ± 26.0 | 53.5 ± 23.7 | 54.7 ± 30.7 | 56.5 ± 25.9 | 0.380 |
| AS etiology | < 0.001* | ||||
| Degenerative | 427 (77.5) | 245 (83.6) | 88 (60.7) | 94 (98.9) | |
| Rheumatic | 35 (6.4) | 23 (7.8) | 12 (8.3) | 0 (0) | |
| Congenital | 64 (11.6) | 21 (7.2) | 42 (29.0) | 1 (1.1) | |
| AV peak velocity (m/sec) | 4.6 ± 0.8 | 4.4 ± 0.9 | 4.8 ± 0.7 | 4.7 ± 0.8 | < 0.001* |
| AV mean PG (mmHg) | 50.9 ± 19.1 | 48.5 ± 19.9 | 54.2 ± 16.5 | 54.8 ± 18.5 | < 0.001* |
| AV area by 2D planimetry (cm2) | 0.79 ± 0.23 | 0.80 ± 0.21 | 0.84 ± 0.30 | 0.72 ± 0.22 | 0.107 |
| AV area by continuity equation (cm2) | 0.73 ± 0.22 | 0.77 ± 0.23 | 0.70 ± 0.19 | 0.68 ± 0.20 | < 0.001* |
| Velocity ratio | 0.23 ± 0.09 | 0.2 ± 0.1 | 0.2 ± 0.1 | 0.2 ± 0.1 | 0.176 |
| Treatment strategy | - | ||||
| Mechanical AVR | 52 (9.4) | 0 (0) | 52 (35.6) | 0 (0) | |
| Bioprosthetic AVR | 94 (17.1) | 0 (0) | 94 (64.4) | 0 (0) | |
| TAVR | 95 (17.2) | 0 (0) | 0 (0) | 95 (100) | |
| In-hospital mortality | 32 (5.8) | 25 (8.1) | 6 (4.1) | 1 (1.1) | < 0.001* |
| Cardiac | 9 (1.6) | 9 (2.9) | 0 (0) | 0 (0) | |
| Noncardiac | 21 (3.8) | 16 (5.2) | 4 (2.7) | 1 (1.1) | |
| Unknown | 2 (0.4) | 0 (0) | 2 (1.4) | 0 (0) | |
Values are presented as mean ± standard deviation or number (%)
AS aortic stenosis, SAVR surgical aortic valve replacement, TAVR transcutaneous aortic valve replacement, NYHA New York Heart Association, MI myocardial infarction, NT-proBNP N-terminal pro B-type natriuretic peptide, LVEDD left ventricular end-diastolic dimension, LVESD left ventricular end-systolic dimension, LVEF left ventricular ejection fraction, LV left ventricle, TR tricuspid regurgitation, Vmax maximal velocity, LA left atrium, AV aortic valve, PG pressure gradient, D dimensional, AVR aortic valve replacement
*P < 0.05