title: Progression of aortic stenosis in the elderly detected by noninvasive methods.
abstract: One hundred eighty consecutive male patients, mean age of 64.6 years, who were referred to cardiac catheterization for the evaluation of aortic stenosis (AS), were studied using a noninvasive scoring system. The system is based upon 7 variables including: 1) LVH by ECG, 2) aortic valve calcium by chest x-ray, 3) loudness of A2, 4) Q to peak of murmur, 5) T time of the carotid pulse, 6) LV ejection time and 7) LVH by echocardiography. The scoring system has a range from 0 to 16, and a score greater than or equal to 5 indicates severe AS (valve area less than or equal to 1.0 cm2). Eighteen patients had hemodynamic studies on two occasions. In 3 years progression of stenosis was evident by an increase in the mean aortic valve gradient from 23 +/- 3.4 mmHg to 44 +/- 4.2 mmHg (p less than 0.005). The aortic valve area decreased from 1.4 +/- 0.1 cm2 to 0.76 +/- 0.07 cm2 (p less than 0.005). Noninvasive scores increased in these patients from 2.1 +/- 0.5 to 7.6 +/- 1.0 (p less than 0.005). Fifty-one patients had repeated noninvasive studies. Twenty-two patients, who had mild AS at the initial evaluation, attained a score of greater than or equal to 5 in 3 years, indicating probable progression to severe AS. The mean initial score was 2.3 +/- 0.4, and the score at the end of the mean follow-up period of 3 years was 8.0 +/- 0.6 (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: 2nd Department of Internal Medicine, Faculty of Medicine, Tokyo Medical and Dental University.
authors.forename: M
authors.initials: M
authors.lastname: Nitta
authors.forename: T
authors.initials: T
authors.lastname: Takamoto
authors.forename: K
authors.initials: K
authors.lastname: Taniguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006328:Cardiac Catheterization; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis