Abstract 11301: Lower Systemic Arterial Compliance is Associated With Increased Cardiovascular Morbidity and Mortality in Aortic Valve Stenosis
Introduction: Systemic arterial compliance (SAC) significantly influences cardiovascular morbidity and mortality in hypertension, but this has not been assessed in a prospective study in aortic stenosis (AS).
Hypothesis: Lower SAC is associated with reduced outcome in AS.
Methods: Data from 1471 patients (38% women) with initially asymptomatic mild-moderate AS enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study was used. Median follow-up was 4.3 years. SAC was assessed as the ratio of stroke volume index to central pulse pressure.
Results: In multivariable linear regression analysis, lower SAC at baseline was associated with older age, hypertension, obesity, presence of a small aortic root and more severe AS (all p<0.001). In Cox regression analysis, lower SAC (per 1 ml/m2/mmHg) was associated with higher hazard rates for major cardiovascular events, aortic valve events, ischemic cardiovascular events and total mortality (all p<0.05), also after adjusting for hypertension, left ventricular mass, AS severity, presence of a small aortic root, randomized study treatment and aortic valve replacement (Table).
Conclusion: In AS patients without known cardiovascular disease, but a high prevalence of hypertension, lower SAC is associated with higher morbidity and mortality independent of other well-known prognosticators. Table. The association of lower SAC with cardiovascular events in asymptomatic AS in multivariable Cox analyses.
Author Disclosures: E. Bahlmann: None. D. Cramariuc: None. M. Lonnebakken: None. C. Gohlke-Baerwolf: None. T. Pedersen: None. C.A. Nienaber: None. J.B. Chambers: None. K. Kuck: None. E. Gerdts: None.
- © 2016 by American Heart Association, Inc.