Abstract 10031: Small Aortic Root Size Has Prognostic Implications Both for Women and Men With Asymptomatic Aortic Stenosis

Abstract

Background: Sex-specific analysis of small aortic root has not been reported in asymptomatic aortic stenosis (AS) patients. Methods: We used echocardiographic and outcome data from 1560 patients with asymptomatic initially mild-moderate AS enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study. A small aortic root was defined as an inner diameter at the aortic sinotubular junction < 1.5cm/m in women and < 1.6cm/m in men. Results: A small aortic root was found in 17.4% patients at baseline and independently associated with higher pulse pressure/stroke volume index and aortic root wall thickness, higher pressure recovery, lower LV mass index and female sex in multivariate logistic regression analysis (all p<0.05). In sex-specific multivariate Cox regression analysis, adjusting for the known prognosticators age, hypertension and AS severity and for randomized study treatment, having a small aortic root predicted a 66% higher rate of ischemic cardiovascular events and a 2-fold higher rate of non-haemorrhagic stroke and cardiovascular death (all p<0.05) in men and a 2-fold higher rate of CABG in women (Table). Presence of small aortic root did not influence total mortality or aortic valve replacement in either gender. Conclusion: In asymptomatic AS patients without known cardiovascular disease or diabetes, having a small aortic root was associated with increased rate of cardiovascular events in both women and men. Table. Small aortic root as predictor of different cardiovascular events in multivariate analyses in women and men [HR (95%CI)].