Abstract

SATUT, ZARAYA et al. Estudio retroprospectivo de la progresión de la estenosis valvular aórtica valorada por gradientes ecocardiográficos. Rev.Urug.Cardiol. [online]. 2004, vol.19, n.1, pp.38-48. ISSN 1688-0420.

Background: aortic stenosis (AS) is the most frequent valve disease in our country, and in many cases requires surgical valve substitution. The purpose of this study was the characterization of AS progression in order to anticipate the need of surgery. Methods: we examined the database of 21.323 echocardiographic studies performed in a laboratory attending ambulatory adult patients, and the evolution of patients with ³ 3 echo studies. Results: AS (maximal transaortic gradient ³ 25 mmHg) was diagnosed in 2.922 (13,7%) studies. The progression of AS was studied in 109 patients with ³ 3 echos in 9 years, and at least one of them with diagnosis or AS. We defined 3 intervals: the initial, between the first and the second study (23,2±12,8 months), the final, between the second and the last (19,6±12 months) and the whole interval, between the first and the last one (42,7±19,2 months). There were no differences between men (56% of all, age 67±11 years) and women (44%, 70±8 years) regarding the characteristics of patients and echocardiographic data. The progression of AS was estimated by the rate of increase of maximal or mean gradients related to the length of each interval (initial, last and whole). The rate of progression of the maximal gradient in the whole interval was 5,9 mmHg/year, and of mean gradient 3,8 mmHg/year, higher in the last interval than in the first one: maximal gradient: 7,8 vs 4,8 mmHg/year; mean gradient: 5,6 vs 2,6 mmHg/year, respectively. In no case were differences found between men and women. In individual cases no correlation was found in the progression of maximal gradients between the first and the last intervals but an inverse correlation was found in the rate of progression of mean gradients. Conclusions: AS is a frequent diagnosis in echo studies performed in an adult ambulatory population. Its progression in this population was higher as the disease evolved. In individual cases it was not possible to anticipate the progression of the disease through the knowledge of the progression in the first interval.

Keywords : ECHOCARDIOGRAPHY; AORTIC VALVE STENOSIS; DISEASE PROGRESSION; EPIDEMIOLOGIC STUDIES.