- In patients with aortic valve stenosis (AS) without diabetes and known cardiovascular disease (CVD), low systemic arterial compliance (SAC) is associated with higher CV and all-cause mortality independent of well-known prognosticators.
Why this matters
- Findings highlight the importance of hypertension and arterial function assessments in addition to stenosis severity in the evaluation of patients with AS.
- A prospective study of 1641 patients with asymptomatic mild-moderate AS who were enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study.
- SAC was evaluated using stroke volume index/central pulse pressure ratio, and all patients were divided into 2 groups: low SAC (lower tertile, SAC2/mmHg; n=545) and normal SAC (n=1096).
- Main outcomes: CV and all-cause mortality.
- Funding: MSP Singapore Company, LLC, Singapore.
- Low SAC at baseline was independently associated with older age, female sex, hypertension, obesity, presence of a small aortic root, lower mean aortic gradient, and energy loss index (P<.01 for all>
- In Cox regression analysis adjusted for confounders, low SAC was associated with increased CV (HR, 2.13; 95% CI, 1.34-3.40) and all-cause mortality (HR, 1.71; 95% CI, 1.23-2.38) (P=.001 for both).
- In univariable Cox analyses, low SAC was associated with higher CV and all-cause mortality in patients with systolic blood pressure:
- ≥130 mmHg (HR, 2.22; 95% CI, 1.42-3.48; P=.001 and HR, 1.71; 95% CI, 1.38-2.64; P<.001 respectively>
- Study did not include patients with atherosclerotic disease or diabetes.