Share this page on LinkedIn
Share This Page on Google+
Share This Page on Twitter
tell someone about this page print this page
You are here: Contents > 2013 > Volume 22 Number 3 May 2013 > AORTIC VALVE DISEASE > Clinical Factors Associated with Classical Symptoms of Aortic Valve Stenosis

Clinical Factors Associated with Classical Symptoms of Aortic Valve Stenosis

Yuji Nishizaki1, Masao Daimon1, Sakiko Miyazaki1, Hiromasa Suzuki1, Takayuki Kawata1, Katsumi Miyauchi1, Shuo-Ju Chiang1, Haruka Makinae2, Tomohiro Shinozaki3, Hiroyuki Daida1

Departments of 1Cardiology and 2Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, 3The University of Tokyo, School of Public Health, Department of Biostatistics, Tokyo, Japan

Background and aim of the study: The recognition of clinical symptoms is critical to a therapeutic strategy for aortic valve stenosis (AS). It was hypothesized that AS symptoms might have multiple causes; hence, a study was conducted to investigate the factors that separately influence the classic symptoms of dyspnea, angina and syncope in AS.

Methods: The medical records of 170 consecutive patients with AS (≥ moderate grade) were reviewed. A multivariate logistic regression analysis was used to evaluate the hemodynamic and clinical factors that separately influence the development of three clinical symptoms: dyspnea (defined as NYHA class ≥2), angina, and syncope.

Results: The most common symptom was dyspnea (47.1%), followed by angina (12.4%) and syncope (4.7%). The factors associated with dyspnea were a higher eʹ ratio (p = 0.04) and peak aortic valve velocity (p = 0.01). Only

the severity of AS was associated with syncope. The presence of hypertension was associated with angina (p = 0.04). Moreover, coronary angiography was performed in 59 patients before aortic valve replacement and revealed coronary stenosis (>50% diameter stenosis) in 11/16 patients (69%) that had angina. The presence of coronary stenosis was significantly associated with angina (p = 0.02). The development of dyspnea, angina or syncope was influenced by different factors in AS.

Conclusion: Dyspnea and syncope were mainly associated with AS severity, and diastolic dysfunction also influenced dyspnea. In contrast, angina was mainly related to the presence of coronary stenosis rather than to AS severity. These factors should be considered when selecting a therapeutic strategy for AS patients in the modern era.

The Journal of Heart Valve Disease 2013;22:287-294

Clinical Factors Associated with Classical Symptoms of Aortic Valve Stenosis

Click the above hyperlink to view the article, right click (Ctrl click on a Mac) to open in a new browser window or tab.

Purchase this Article

Please click the button below to purchase this article. Single article purchases are provided at $50.00 per article. Upon clicking the button below, single article user account subscription details are requested and, upon successful payment, a single article user account is created. Single articles are availble in your account for seven days after purchase.