Echo predicts mortality in untreated aortic stenosis with normal LV function

JUNE17, 2011 | Marlene Busko

Montreal, QC - Researchers have identified four echo markers that predicted mortality in elderly patients with severe aortic stenosis but preserved LV function who did not undergo surgical valve replacement [1]. Dr Eddy Barasch (St Francis Hospital, Roslyn, NY) presented the study here at the American Society of Echocardiography (ASE) 2011 Scientific Sessions.

The four echocardiographic markers that predicted poor survival were greater left ventricle (LV) concentric remodeling, lower stroke volume, elevated LV filling pressures, and mildly elevated pulmonary artery pressure.

"Our findings may not be generalizable, but they suggest that in [elderly, symptomatic patients with untreated aortic stenosis] with normal LV function, no other valve disease, and normal sinus rhythm, these echocardiographic parameters may be useful for risk stratification," Barasch told heartwire. Being able to predict mortality with surgery vs medical therapy in patients such as these—who are typical of patients seen in clinical practice—will become even more important when transcatheter aortic-valve implantation (TAVI) becomes available, he added.

The data suggest that "not operating on symptomatic patients like this—with these markers—is really a death sentence," said Dr Malissa Wood (Massachusetts General Hospital Heart Center, Boston), when asked to comment on the study."When you are managing patients who may in fact be good candidates for surgery, looking at their echo and figuring out if they have these risk factors can help determine the patients' overall risk of mortality with surgery vs medical therapy," she added./.../