The Clinical Implications of Body Surface Area as a Poor Proxy for Cardiac Output

BackgroundProsthesis-patient mismatch (PPM), routinely used to characterize the degree of hemodynamic obstruction caused by a prosthetic heart valve, is associated with adverse patient outcomes after aortic valve replacement (AVR). In common definition PPM, opening area related patients’ cardiac output, indexing effective orifice (EOA) body surface (BSA). The aim this study assess implications using BSA as proxy for output.Methods744 patients normal LV function underwent echocardiographic assessment surgical AVR. To validate use relation between these variables was analyzed. effects on classification PPM (EOAi < 0.85 cm2/m2) and presence (mean gradient ? 20 mmHg and/or Doppler velocity index 0.35) were estimated.ResultsThere weak correlation output (r: 0.29, 95% CI: 0.22;0.35), not proportional (Cardiac = 1.5 x +1.9). As result, increased risk large be labelled (OR: 5.2, 2.5,11 per m2 BSA), reflected significantly higher 1.5, 0.5,4.9 BSA).ConclusionsThe current results in systematic overestimation larger BSA, we recommend cautious subgroup.Abbreviations: AVR: Aortic replacement; BMI: Body mass index; BSA: area; EOA: Effective EOAi: Indexed LVOT: Left ventricular outflow tract; PERIGON: PERIcardial SurGical AOrtic Valve ReplacemeNt Pivotal Trial; PPM: Prosthesis-patient mismatch; TTE: Transthoracic echocardiography; VARC-2: Academic Research Consortium-2.