Prediction of aortic stenosis-related events in patients with systolic ejection murmur using pocket-sized echocardiography

Background: We have previously reported the usefulness of our newly developed visual aortic stenosis (AS) score in screening for AS using pocket-sized echocardiography. The objective of this study was to investigate whether the visual AS score and/or conventional aortic valve calcification score derived from pocket-sized echocardiography can be used to predict AS-related events. Methods: One hundred and nine patients with systolic ejection murmur (SEM) or known AS (64 males, age 75 +/- 9 years) were enrolled and a visual AS score and an aortic valve calcification score were assessed using pocket-sized echocardiography. The primary endpoint was defined as AS-related events, including cardiac death and aortic valve replacement, during the follow-up period. Results: In a multivariate Cox proportional hazards analysis, AS-related events were independently predicted by an aortic valve calcification score >= 3 (HR, 3.5; 95% CI, 1.1-11; p = 0.033) and a visual AS score >= 3 (HR, 15; 95% CI, 1.8-125; p = 0.013). During 18 +/- 9 months of follow-up, the event-free survival rate was 98% in patients with both a visual AS score <3 and an aortic valve calcification score <3, 90% in patients with either a visual AS score >= 3 or an aortic valve calcification score >= 3 (p < 0.0001), and 62% in patients with both a visual AS score >= 3 and an aortic valve calcification score >= 3 (p < 0.0001). Conclusions: The combination of visual AS score and aortic valve calcification score derived from pocket sized echocardiography is useful for predicting AS-related events in patients with SEM. (C) 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.