Introduction
Methods
Study population
Statistical analysis
Imaging modalities
Transthoracic echocardiography (TTE)
3D image analysis of MSCT
Results
Baseline characteristics
AVC thresholds according to AS severity
Echocardiography and MSCT M = male; F = female | AVA > 1.0 cm2 (n = 97) M = 53; F = 44 | p value | AVA ≤ 1.0 cm2 (n = 841) M = 390; F = 451 | p value | pAS-severity |
---|---|---|---|---|---|
M AVA, cm2 | 1.2 ± 0.1 | 0.069 | 0.7 ± 0.2 | < 0.0001* | < 0.0001* |
F AVA, cm2 | 1.1 ± 0.1 | 0.7 ± 0.2 | < 0.0001* | ||
M dPmean, mmHg | 25.1 ± 8.8 | 0.359 | 37.1 ± 15.0 | 0.007* | < 0.0001* |
F dPmean, mmHg | 23.4 ± 9.6 | 40.1 ± 16.6 | < 0.0001* | ||
M LVEF, % | 49.5 ± 14.6 | 0.007* | 52.2 ± 13.3 | < 0.0001* | 0.292 |
F LVEF, % | 60.5 ± 14.5 | 58.0 ± 12.5 | 0.334 | ||
M AVC, AU | 1365 [827–2106] | < 0.0001* | 2245 [1418–3340] | < 0.0001* | < 0.0001* |
F AVC, AU | 642 [407–1124] | 1388 [772–2187] | < 0.0001* | ||
M AVC density, AU/cm2 | 228 [162–411] | 0.002* | 414 [265–602] | < 0.0001* | < 0.0001* |
F AVC density, AU/cm2 | 157 [98–243] | 322 [184–492] | < 0.0001* | ||
M NCC, AU | 482 [283–1025] | < 0.0001* | 868 [502–1364] | < 0.0001* | 0.001* |
F NCC, AU | 241 [89–433] | 572 [268–1042] | < 0.0001* | ||
M NCC density, AU/cm2 | 95 [54–173] | 0.001* | 158 [95–253] | 0.001* | < 0.0001* |
F NCC density, AU/cm2 | 49 [25–104] | 132 [65–235] | < 0.0001* | ||
M RCC, AU | 361 [159–641] | < 0.0001* | 641 [362–1085] | < 0.0001* | < 0.0001* |
F RCC, AU | 170 [48–360] | 364 [200–652] | < 0.0001* | ||
M RCC density, AU/cm2 | 65 [29–131] | 0.019* | 113 [65–195] | < 0.0001* | < 0.0001* |
F RCC density, AU/cm2 | 45 [12–76] | 83 [44–155] | < 0.0001* | ||
M LCC, AU | 330 [160–571] | 0.002* | 607 [329–1032] | < 0.0001* | < 0.0001* |
F LCC, AU | 193 [79–309] | 326 [165–626] | 0.0001* | ||
M LCC density, AU/cm2 | 65 [36–100] | 0.055 | 111 [61–178] | < 0.0001* | < 0.0001* |
F LCC density, AU/cm2 | 46 [21–71] | 79 [38–145] | < 0.0001* | ||
M LVOT, AU | 15 [0–157] | 0.202 | 32 [0–176] | 0.820 | 0.661 |
F LVOT, AU | 4 [0–75] | 34 [2–189] | 0.027* | ||
M LVOT density, AU/cm2 | 4 [0–24] | 0.272 | 6 [0–30] | 0.266 | 0.623 |
F LVOT density, AU/cm2 | 1 [0–19] | 6 [0–42] | 0.023* |
AVC thresholds according to AS entity
Echocardiography and MSCT M = male; F = female | HGAS (n = 370) M = 156; F = 214 | p value | pLGAS (n = 333) M = 144; F = 189 | p value | LGAS (n = 138) M = 90; F = 48 | p value | pANOVA |
---|---|---|---|---|---|---|---|
M LVEF, % | 55.2 ± 12.9# | 0.002* | 58.5 ± 8.3# | 0.027* | 35.9 ± 10.1 | 0.499 | < 0.0001* n.s# |
F LVEF, % | 60.3 ± 11.4# | 61.1 ± 8.5# | 37.4 ± 10.3 | < 0.0001* n.s# | |||
M AVA, cm2 | 0.7 ± 0.2 | < 0.0001* | 0.8 ± 0.2# | 0.130 | 0.8 ± 0.1# | 0.108 | < 0.0001* n.s# |
F AVA, cm2 | 0.6 ± 0.2 | 0.8 ± 0.1# | 0.7 ± 0.1# | < 0.0001* n.s# | |||
M dPmean, mmHg | 51.3 ± 11.7 | 0.045* | 29.0 ± 7.0 | 0.369 | 25.7 ± 8.4 | 0.822 | < 0.0001* |
F dPmean, mmHg | 53.8 ± 12.2 | 28.2 ± 7.5 | 25.4 ± 8.6 | < 0.0001* | |||
M AVC, AU | 3076 [2211–3884] | < 0.0001* | 1893 [1085–2715]# | < 0.0001* | 1644 [1127–2639]# | < 0.0001* | < 0.0001* n.s# |
F AVC, AU | 1785 [1237–2720] | 1014 [610–1666]# | 1007 [521–1547]# | < 0.0001* n.s# | |||
M AVC density, AU/cm2 | 551 [401–707] | 0.001* | 333 [216–481]# | < 0.0001* | 322 [220–490]# | 0.004* | < 0.0001* n.s# |
F AVC density, AU/cm2 | 424 [292–625] | 244 [144–389]# | 230 [123–340]# | < 0.0001* n.s# | |||
M NCC, AU | 1138 [737–1789] | < 0.0001* | 703 [424–1224]# | < 0.0001* | 631 [407–1086]# | 0.005* | < 0.0001* n.s# |
F NCC, AU | 751 [437–1228] | 379 [169–731]# | 416 [238–753]# | < 0.0001* n.s# | |||
M NCC density, AU/cm2 | 206 [134–308] | 0.045* | 125 [82–213]# | < 0.0001* | 124 [76–204]# | 0.121 | < 0.0001* n.s# |
F NCC density, AU/cm2 | 175 [97–288] | 92 [41–153]# | 104 [62–169]# | < 0.0001* n.s# | |||
M RCC, AU | 970 [493–1389] | < 0.0001* | 495 [246–844]# | < 0.0001* | 538 [296–832]# | < 0.0001* | < 0.0001* n.s# |
F RCC, AU | 534 [276–800] | 280 [151–519]# | 232 [103–382]# | < 0.0001* n.s# | |||
M RCC density, AU/cm2 | 167 [98–244] | < 0.0001* | 93 [51–142]# | 0.003* | 97 [56–148]# | < 0.0001* | < 0.0001* n.s# |
F RCC density, AU/cm2 | 126 [70–199] | 68 [34–115]# | 52 [27–78]# | < 0.0001* n.s# | |||
M LCC, AU | 822 [521–1172] | < 0.0001* | 456 [264–7800]# | < 0.0001* | 500 [261–723]# | < 0.0001* | < 0.0001* n.s# |
F LCC, AU | 452 [254–811] | 244 [131–442]# | 208 [97–428]# | 0.0003* n.s# | |||
M LCC density, AU/cm2 | 148 [97–210] | 0.010* | 83 [48–151]# | < 0.0001* | 96 [51–131]# | 0.001* | < 0.0001* n.s# |
F LCC density, AU/cm2 | 108 [59–182] | 55 [30–104]# | 50 [24–99]# | < 0.0001* n.s# | |||
M LVOT, AU | 55 [0–260]# | 0.761 | 33 [0–151]# | 0.392 | 17 [0–101]# | 0.759 | 0.227 n.s# |
F LVOT, AU | 65 [5–238]# | 10 [0–95]# | 26 [0–166]# | 0.544 n.s# | |||
M LVOT density, AU/cm2 | 9 [0–48]# | 0.235 | 6 [0–27]# | 0.629 | 3 [0–20]# | 0.589 | 0.168 n.s# |
F LVOT density, AU/cm2 | 16 [1–56]# | 3 [0–19]# | 5 [0–35]# | 0.582 n.s# |
Parameters | Entities | AUC | p value | Lower 95% CI | Upper 95% CI | Threshold | Sensitivity (%) | Specificity (%) | LR |
---|---|---|---|---|---|---|---|---|---|
Overall data | |||||||||
AVC (AU) male | HGAS | 0.76 | < 0.0001 | 0.69 | 0.83 | > 2156 | 65 | 79 | 3.1 |
pLGAS | 0.62 | 0.0081 | 0.53 | 0.71 | > 1581 | 63 | 62 | 1.7 | |
LGAS | 0.61 | 0.0348 | 0.51 | 0.70 | > 1589 | 53 | 62 | 1.4 | |
AVC (AU) female | HGAS | 0.85 | < 0.0001 | 0.79 | 0.91 | > 1540 | 62 | 93 | 9.0 |
pLGAS | 0.66 | 0.0012 | 0.57 | 0.74 | > 1016 | 50 | 73 | 1.8 | |
LGAS | 0.62 | 0.0425 | 0.51 | 0.74 | > 1012 | 50 | 73 | 1.8 | |
AVC (AU/cm2) male | HGAS | 0.82 | < 0.0001 | 0.76 | 0.89 | > 406 | 75 | 75 | 3.0 |
pLGAS | 0.63 | 0.0050 | 0.54 | 0.72 | > 323 | 52 | 72 | 1.8 | |
LGAS | 0.62 | 0.0196 | 0.54 | 0.72 | > 322 | 51 | 72 | 1.8 | |
AVC (AU/cm2) female | HGAS | 0.86 | < 0.0001 | 0.81 | 0.92 | > 259 | 80 | 80 | 3.9 |
pLGAS | 0.66 | 0.0008 | 0.58 | 0.75 | > 192 | 62 | 68 | 2.0 | |
LGAS | 0.63 | 0.00310 | 0.52 | 0.74 | > 180 | 63 | 66 | 1.8 | |
B) Adapted to LVF | |||||||||
AVC (AU) male | HGAS | 0.76 | < 0.0001 | 0.68 | 0.85 | > 2156 | 76 | 72 | 2.8 |
pLGAS | 0.54 | 0.4108 | 0.44 | 0.65 | > 1754 | 55 | 56 | 1.2 | |
LGAS | 0.79 | 0.0002 | 0.67 | 0.90 | > 1092 | 78 | 76 | 3.3 | |
AVC (AU) female | HGAS | 0.86 | < 0.0001 | 0.80 | 0.93 | > 1137 | 80 | 80 | 4.0 |
pLGAS | 0.66 | 0.0022 | 0.57 | 0.75 | > 848 | 58 | 63 | 1.6 | |
LGAS | 0.60 | 0.3580 | 0.40 | 0.79 | > 1012 | 50 | 67 | 1.5 | |
AVC (AU/cm2) male | HGAS | 0.78 | < 0.0001 | 0.70 | 0.86 | > 506 | 59 | 78 | 2.7 |
pLGAS | 0.54 | 0.4314 | 0.44 | 0.65 | > 320 | 53 | 61 | 1.4 | |
LGAS | 0.81 | < 0.0001 | 0.71 | 0.92 | > 228 | 75 | 88 | 6.4 | |
AVC (AU/cm2) female | HGAS | 0.87 | < 0.0001 | 0.81 | 0.93 | > 275 | 80 | 83 | 4.6 |
pLGAS | 0.67 | 0.0045 | 0.58 | 0.75 | > 178 | 65 | 69 | 2.1 | |
LGAS | 0.63 | 0.2287 | 0.43 | 0.82 | > 231 | 50 | 78 | 2.3 | |
NCC (AU) male | HGAS | 0.70 | 0.0003 | 0.60 | 0.80 | > 1178 | 50 | 78 | 2.2 |
pLGAS | 0.53 | 0.6028 | 0.42 | 0.63 | > 656 | 55 | 56 | 1.2 | |
LGAS | 0.77 | 0.0004 | 0.65 | 0.89 | > 370 | 80 | 76 | 3.4 | |
NCC (AU) female | HGAS | 0.81 | < 0.0001 | 0.73 | 0.90 | > 491 | 72 | 80 | 3.6 |
pLGAS | 0.64 | 0.0074 | 0.54 | 0.74 | > 277 | 63 | 63 | 1.7 | |
LGAS | 0.67 | 0.0985 | 0.48 | 0.87 | > 286 | 65 | 78 | 2.9 | |
NCC (AU/cm2) male | HGAS | 0.70 | 0.0002 | 0.61 | 0.80 | > 193 | 56 | 78 | 2.5 |
pLGAS | 0.52 | 0.6549 | 0.42 | 0.63 | > 114 | 60 | 50 | 1.2 | |
LGAS | 0.77 | 0.0004 | 0.65 | 0.90 | > 63 | 79 | 76 | 3.3 | |
NCC (AU/cm2) female | HGAS | 0.83 | < 0.0001 | 0.75 | 0.90 | > 115 | 74 | 83 | 4.3 |
pLGAS | 0.64 | 0.0075 | 0.42 | 0.63 | > 74 | 60 | 69 | 1.9 | |
LGAS | 0.69 | 0.0660 | 0.49 | 0.90 | > 70 | 63 | 78 | 2.8 | |
RCC (AU) male | HGAS | 0.76 | < 0.0001 | 0.67 | 0.85 | > 718 | 66 | 78 | 2.9 |
pLGAS | 0.55 | 0.6228 | 0.45 | 0.66 | > 415 | 60 | 58 | 1.5 | |
LGAS | 0.72 | 0.0054 | 0.58 | 0.85 | > 157 | 89 | 50 | 1.8 | |
RCC (AU) female | HGAS | 0.82 | < 0.0001 | 0.75 | 0.89 | > 324 | 74 | 80 | 3.7 |
pLGAS | 0.68 | 0.0010 | 0.58 | 0.77 | > 192 | 71 | 60 | 1.8 | |
LGAS | 0.51 | 0.9042 | 0.28 | 0.75 | < 249 | 54 | 67 | 1.6 | |
RCC (AU/cm2) male | HGAS | 0.77 | < 0.0001 | 0.69 | 0.86 | > 149 | 60 | 75 | 2.4 |
pLGAS | 0.54 | 0.4473 | 0.43 | 0.65 | > 76 | 63 | 61 | 1.6 | |
LGAS | 0.72 | 0.0054 | 0.58 | 0.85 | > 42 | 81 | 59 | 2.0 | |
pLGAS | 0.67 | 0.0018 | 0.57 | 0.76 | > 52 | 63 | 63 | 1.7 | |
LGAS | 0.53 | 0.7677 | 0.65 | 0.90 | < 60 | 56 | 67 | 1.7 | |
LCC (AU) male | HGAS | 0.75 | < 0.0001 | 0.66 | 0.85 | > 427 | 81 | 67 | 2.4 |
pLGAS | 0.57 | 0.2068 | 0.46 | 0.67 | > 423 | 53 | 67 | 1.6 | |
LGAS | 0.73 | 0.0032 | 0.60 | 0.85 | > 331 | 63 | 71 | 2.2 | |
LCC (AU) female | HGAS | 0.78 | < 0.0001 | 0.70 | 0.86 | > 319 | 64 | 83 | 3.8 |
pLGAS | 0.60 | 0.0621 | 0.50 | 0.70 | > 230 | 52 | 60 | 1.3 | |
LGAS | 0.52 | 0.8869 | 0.32 | 0.71 | > 211 | 50 | 67 | 1.5 | |
LCC (AU/cm2) male | HGAS | 0.76 | < 0.0001 | 0.67 | 0.85 | > 98 | 75 | 69 | 2.5 |
pLGAS | 0.57 | 0.2100 | 0.46 | 0.67 | > 74 | 58 | 53 | 1.2 | |
LGAS | 0.75 | 0.0012 | 0.63 | 0.86 | > 40 | 84 | 53 | 1.8 | |
LCC (AU/cm2) female | HGAS | 0.78 | < 0.0001 | 0.70 | 0.86 | > 67 | 73 | 77 | 3.2 |
pLGAS | 0.60 | 0.0680 | 0.50 | 0.69 | > 52 | 54 | 57 | 1.3 | |
LGAS | 0.54 | 0.7262 | 0.35 | 0.72 | > 46 | 54 | 67 | 1.6 |