Annual rate of progression of aortic-jet velocity and survival in cases of severe asymptomatic aortic stenosis.

(Full text is available at http://www.manu.edu.mk/prilozi). The aim of the study was to establish the predictive role of maximal aortic-jet velocity, i.e. its annual rate of progression, in the decision in favour of aortic valve replacement (AVR), as well as in the event appearance and/or patients' survival with severe asymptomatic aortic stenosis. 49 patients were analysed who belonged to the clinical and echocardiography group with severe asymptomatic valve aortic stenosis, with an average of 22 +/- 10 months follow-up period. The echocardiography parameters were: ejection fraction, maximal aortic-jet velocity (AV_Vmax), trans-valve maximal gradient and aortic valve area, as well as calcification rate, all of which were included in the predictive model. The progression rate of the aortic-jet velocity was established, reduced to an annual level. The variable ECHO status worsening was defined as worsening when the progression rate of the AV_Vmax at the annual level was > or = 0.3 mps per year. The results show that in 20% of the patients an annual rate of progression of the aortic-jet velocity over > or = 0.3 mps per year was registered. For the follow-up period, event appearance was registeredin 20% of the patients , where the risk of event appearance is 4.3 times higher in patients with ECHO worsening status, in relation to those without ECHO worsening status. It was established the that the probability of survival of the asymptomatic patients with severe AS over a period of 3 years was 0.57 +/- 0.11. The average length of survival in patients without ECHO worsening status was 32.8 +/- 1 months, while in patients with ECHO worsening status it was 23.5 +/- 4 months. It can be conclude that the maximal trans-valve aortic-jet velocity, especially the rate of its annual progression, is a significant predictor of the rapid progression of the disease, which contributes to the risk stratification in the risk group of patients with severe asymptomatic aortic stenosis while referring for AVR. Key words: severe asymptomatic valve aortic stenosis, echocardiography, annual rate of progression of the maximal aortic-jet velocity, survival.