PDF(Pubmed)
Abstract：
UNASSIGNED: Symptoms associated with severe aortic stenosis (AS) are used to guide management.
UNASSIGNED: The purpose of this study was to examine the pattern of symptoms, comorbidities, and cardiac damage in moderate and severe AS.
UNASSIGNED: A total of 846,198 echocardiographic investigations from 330,940 individuals aged >18 years were selected for the most recent echocardiogram, moderate or severe AS (mean gradient 20.0-39.9 mm Hg, aortic valve peak gradient 3.0-3.9 m/s and aortic valve area >1.0 cm2; or ≥ 40.0 mm Hg, ≥4.0 m/s or ≤1.0 cm2, respectively), and a cardiologist consultation. Natural Language Processing was applied to letters to extract comorbidities, dyspnea, chest pain, and syncope. Patients with prior aortic valve replacement were excluded.
UNASSIGNED: 2,213 patients (0.7% overall, 32.8% females) had moderate and 3,416 (1.0%, 47.3% females) had severe AS. Comorbidities were common, including hypertension, (56.6% moderate AS, 53.1% severe AS, P = 0.01), coronary disease (46.0% and 46.8%, respectively, P = 0.58) and atrial fibrillation (29.6% and 34.8%, respectively, P < 0.001). Symptoms were also common in both moderate (n = 915, 41.3%) and severe (n = 1,630, 47.7%) AS (P < 0.001). Comorbidities were more likely in symptomatic vs asymptomatic patients (P < 0.001). Dyspnea was more likely in severe AS, whereas angina and syncope were similar in moderate vs severe AS. In multivariable analysis, only dyspnea was associated with severe (vs moderate) AS (OR: 1.73, 95% CI: 1.41-2.13, P < 0.001). In both adjusted and unadjusted models, the degree of cardiac damage did not relate to presence of any symptoms but was associated with AS severity.
UNASSIGNED: Dyspnea is common in both moderate and severe AS, is associated with comorbidities and is not related to the degree of cardiac damage. Symptom-guided management decisions in AS may need revision.
UNASSIGNED: The purpose of this study was to examine the pattern of symptoms, comorbidities, and cardiac damage in moderate and severe AS.
UNASSIGNED: A total of 846,198 echocardiographic investigations from 330,940 individuals aged >18 years were selected for the most recent echocardiogram, moderate or severe AS (mean gradient 20.0-39.9 mm Hg, aortic valve peak gradient 3.0-3.9 m/s and aortic valve area >1.0 cm2; or ≥ 40.0 mm Hg, ≥4.0 m/s or ≤1.0 cm2, respectively), and a cardiologist consultation. Natural Language Processing was applied to letters to extract comorbidities, dyspnea, chest pain, and syncope. Patients with prior aortic valve replacement were excluded.
UNASSIGNED: 2,213 patients (0.7% overall, 32.8% females) had moderate and 3,416 (1.0%, 47.3% females) had severe AS. Comorbidities were common, including hypertension, (56.6% moderate AS, 53.1% severe AS, P = 0.01), coronary disease (46.0% and 46.8%, respectively, P = 0.58) and atrial fibrillation (29.6% and 34.8%, respectively, P < 0.001). Symptoms were also common in both moderate (n = 915, 41.3%) and severe (n = 1,630, 47.7%) AS (P < 0.001). Comorbidities were more likely in symptomatic vs asymptomatic patients (P < 0.001). Dyspnea was more likely in severe AS, whereas angina and syncope were similar in moderate vs severe AS. In multivariable analysis, only dyspnea was associated with severe (vs moderate) AS (OR: 1.73, 95% CI: 1.41-2.13, P < 0.001). In both adjusted and unadjusted models, the degree of cardiac damage did not relate to presence of any symptoms but was associated with AS severity.
UNASSIGNED: Dyspnea is common in both moderate and severe AS, is associated with comorbidities and is not related to the degree of cardiac damage. Symptom-guided management decisions in AS may need revision.
摘要：
■与严重主动脉瓣狭窄（AS）相关的症状用于指导治疗。
■这项研究的目的是检查症状的模式，合并症,中度和重度AS的心脏损害。
■总共选择了来自330,940名年龄>18岁的个体的846,198例超声心动图检查，用于最近的超声心动图检查。中度或重度AS（平均梯度20.0-39.9mmHg，主动脉瓣峰值梯度3.0-3.9m/s，主动脉瓣面积>1.0cm2；或≥40.0mmHg，分别≥4.0m/s或≤1.0cm2)，还有心脏病专家会诊.自然语言处理被应用于字母来提取合并症，呼吸困难,胸痛,和晕厥。先前主动脉瓣置换术的患者被排除在外。
■2,213名患者（总体占0.7％，32.8%的女性)有中度和3,416(1.0%，47.3％的女性）患有严重的AS。合并症很常见，包括高血压,(56.6%中度AS，53.1%严重AS,P=0.01),冠心病(46.0%和46.8%，分别,P=0.58）和心房颤动（29.6%和34.8%，分别,P<0.001)。在中度（n=915，41.3％）和重度（n=1,630，47.7％）AS中，症状也很常见（P<0.001）。有症状患者与无症状患者合并症的可能性更高（P<0.001）。严重AS患者更可能出现呼吸困难,而中度和重度AS的心绞痛和晕厥相似。在多变量分析中，只有呼吸困难与重度（与中度）AS相关（OR：1.73，95％CI：1.41-2.13，P<0.001）。在调整和未调整的模型中，心脏损伤程度与出现任何症状无关,但与AS严重程度相关.
■呼吸困难在中度和重度AS中都很常见，与合并症相关，与心脏损伤程度无关。AS中症状引导的管理决策可能需要修订。
■这项研究的目的是检查症状的模式，合并症,中度和重度AS的心脏损害。
■总共选择了来自330,940名年龄>18岁的个体的846,198例超声心动图检查，用于最近的超声心动图检查。中度或重度AS（平均梯度20.0-39.9mmHg，主动脉瓣峰值梯度3.0-3.9m/s，主动脉瓣面积>1.0cm2；或≥40.0mmHg，分别≥4.0m/s或≤1.0cm2)，还有心脏病专家会诊.自然语言处理被应用于字母来提取合并症，呼吸困难,胸痛,和晕厥。先前主动脉瓣置换术的患者被排除在外。
■2,213名患者（总体占0.7％，32.8%的女性)有中度和3,416(1.0%，47.3％的女性）患有严重的AS。合并症很常见，包括高血压,(56.6%中度AS，53.1%严重AS,P=0.01),冠心病(46.0%和46.8%，分别,P=0.58）和心房颤动（29.6%和34.8%，分别,P<0.001)。在中度（n=915，41.3％）和重度（n=1,630，47.7％）AS中，症状也很常见（P<0.001）。有症状患者与无症状患者合并症的可能性更高（P<0.001）。严重AS患者更可能出现呼吸困难,而中度和重度AS的心绞痛和晕厥相似。在多变量分析中，只有呼吸困难与重度（与中度）AS相关（OR：1.73，95％CI：1.41-2.13，P<0.001）。在调整和未调整的模型中，心脏损伤程度与出现任何症状无关,但与AS严重程度相关.
■呼吸困难在中度和重度AS中都很常见，与合并症相关，与心脏损伤程度无关。AS中症状引导的管理决策可能需要修订。
