title: Prediction of aortic stenosis-related events in patients with systolic ejection murmur using pocket-sized echocardiography.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Department of Cardiology, Osaka City General Hospital, Osaka, Japan. Electronic address: attin9862@hotmail.com.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Furukawa
authors.affiliation: Department of Cardiology, Osaka City General Hospital, Osaka, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Department of Cardiology, Osaka City General Hospital, Osaka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Cardiology, Osaka City General Hospital, Osaka, Japan.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Tanaka
authors.affiliation: Department of Cardiology, Osaka City General Hospital, Osaka, Japan.
authors.forename: Kazato
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Cardiology, Osaka City General Hospital, Osaka, Japan.
authors.forename: Ryushi
authors.initials: R
authors.lastname: Komatsu
authors.affiliation: Department of Cardiology, Osaka City General Hospital, Osaka, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Haze
authors.affiliation: Department of Cardiology, Osaka City General Hospital, Osaka, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Naruko
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Medical School, Osaka, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.affiliation: Department of Cardiology, Nishinomiya-Watanabe Cardiovascular Center, Nishinomiya, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D012720:Severity of Illness Index; D054160:Systolic Murmurs / Q000209:etiology*
keywords: Aortic stenosis; Echocardiography; Pocket-sized imaging device; Prognosis; Risk stratification