Utility of Preload Stress Echocardiography in Patients with Preserved Ejection Fraction and Low Gradient Aortic Stenosis

Research Project

Project/Area Number	15K19381
Research Category	Grant-in-Aid for Young Scientists (B)
Allocation Type	Multi-year Fund
Research Field	Cardiovascular medicine
Research Institution	The University of Tokushima
Principal Investigator	KUSUNOSE Kenya 徳島大学, 病院, 助教 (70507649)
Project Period (FY)	2015-04-01 – 2017-03-31
Project Status	Completed (Fiscal Year 2016)
Budget Amount *help	¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000) Fiscal Year 2016: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000) Fiscal Year 2015: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Keywords	大動脈弁狭窄症
Outline of Final Research Achievements	Objectives: Our study aimed to identify the independent and incremental value of preload stress echocardiography-derived projected aortic valve area (AVAproj) to predict outcomes in patients with preserved ejection fraction and low-gradient (LG) aortic stenosis (AS). Methods: We prospectively performed echocardiographic studies in 79 LG AS patients (age 77±7 years; 30% male) with preload stress echocardiography using leg positive pressure (LPP). AVAproj was calculated using AVA and transvalvular flow rate at baseline and during LPP. Results: During a median period of 19 months, 23 patients had the decision for AVR and none died during follow-up. In a stepwise multivariate analysis, indexed AVAproj (AVAiproj) (hazard ratio: 2.00 per 0.1 cm2/m2 decrease, 95% confidence interval: 1.36 to 2.96, p <0.001) was associated with the primary endpoint. Conclusions: In LG AS patients, indexed AVAproj derived from preload stress echocardiography is useful to predict risk of adverse events.