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Can left ventricular hypertrophy on electrocardiography detect severe aortic valve stenosis?

美野 多佳志 近畿大学

2023.01.12

概要

Background
Severe aortic stenosis (AS) is increasing in the aging society and is a serious condition for anesthetic management. However, approximately one-third of patients with severe AS are asymptomatic. Echocardiography is the most reliable method to detect AS, but it takes time and is costly.

Methods
Data were obtained retrospectively from patients who underwent surgery and preoperative transthoracic echocardiography (TTE). LVH on ECG was determined by voltage criteria (Sv1 + Rv5 or 6 ≥3.5 mV) and/or the strain pattern in V5 and V6. Severe AS was defined as a mean transaortic pressure gradient ≥40 mmHg or aortic valve area ≤1.0 cm2 by TTE.

Results
Data for 470 patients aged 28–94 years old were obtained. One hundred and twenty-six patients had severe AS. LVH on ECG by voltage criteria alone was detected in 182 patients, LVH by strain pattern alone was detected in 80 patients and LVH by both was detected in 55 patients. Multivariable logistic analysis revealed that LVH by the strain pattern or voltage criteria, diabetes mellitus, and age were significantly associated with severe AS. The AUC for the ROC curve for LVH by voltage criteria alone was 0.675 and the cut-off value was 3.84 mm V, and the AUC for the ROC for age was 0.675 and the cut-off value was 74 years old.

Conclusion
Our study suggests that patients who are 74 years old or over with LVH on ECG, especially those with DM, should undergo preoperative TTE in order to detect severe AS.

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参考文献

1. Pislaru SV, Abel MD, Schaff HV, Pellikka PA. Aortic stenosis and noncardiac surgery: managing the risk. Curr Prob Cardiol. 2015; 40: 483–503. https://doi.org/10.1016/j.cpcardiol.2015.06.003 PMID: 26471206

2. Samarendra P, Mangione MP. Aortic stenosis and preoperative risk with noncardiac surgery. J Am Coll Cardiol. 2015; 65: 295–302. https://doi.org/10.1016/j.jacc.2014.10.051 PMID: 25614427

3. Torsher LC, Shub C, Rettke SR, Brown DL. Risk of patients with severe aortic stenosis undergoing noncardiac surgery. Am J Cardiol. 1998; 81: 448–452. https://doi.org/10.1016/s0002-9149(97)00926-0 PMID: 9485135

4. Kertai MD, Bountioukos M, Boersma E, Bax JJ, Thomson IR, Sozzi F, et al. Aortic stenosis: an underestimated risk factor for perioperative complications in patients undergoing noncardiac surgery. Am J Med. 2004; 116: 8–13. https://doi.org/10.1016/j.amjmed.2003.07.012 PMID: 14706659

5. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll of Cardiol. 2014; 63: 2438–2488.

6. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet. 2006; 368: 1005–1011. https://doi.org/10.1016/ S0140-6736(06)69208-8 PMID: 16980116

7. Brown J, Morgan-Hughes NJ. Aortic stenosis and non-cardiac surgery. Continuing Education in Anaesthesia Critical Care & Pain. 2005; 5: 1–4.

8. Tribouilloy C, Rusinaru D, Bohbot Y, Mare´chaux S, Vanoverschelde JL, Enriquez-Sarano M. How should very severe aortic stenosis be defined in asymptomatic individuals? J Am Heart Assoc. 2019 Feb 5; 8(3):e011724. https://doi.org/10.1161/JAHA.118.011724 PMID: 30712451

9. Verdecchia P, Dovellini EV, Gorini M, Gozzelino G, Lucci D, Milletich A, et al. Comparison of electrocardiographic criteria for diagnosis of left ventricular hypertrophy in hypertension: the MAVI study. Ital Heart J. 2000; 1: 207–215. PMID: 10806988

10. Sokolow M, Lyon TP. The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J. 1949; 37: 161–186. https://doi.org/10.1016/0002-8703(49) 90562-1 PMID: 18107386

11. Hancock EW, Deal BJ, Mirvis DM, Okin P, Kligfield P, Gettes LS, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part V: electrocardiogram changes associated with cardiac chamber hypertrophy: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol. 2009; 53: 992–1002. https://doi.org/10. 1016/j.jacc.2008.12.015 PMID: 19281932

12. Shah ASV, Chin CWL, Vassiliou V, Cowell SJ, Doris M, Kwok TC, et al. Left ventricular hypertrophy with strain and aortic stenosis. Circulation. 2014; 130: 1607–1616. https://doi.org/10.1161/ CIRCULATIONAHA.114.011085 PMID: 25170097

13. Kanda Y. Investigation of the freely-available easy-to-use software “EZR” (Easy R) for medical statistics. Bone Marrow Transplant. 2013; 48: 452–458. https://doi.org/10.1038/bmt.2012.244 PMID: 23208313

14. Osnabrugge RLJ, Mylotte D, Head SJ, Van Mieghem NM, Nkomo VT, LeReun CM, et al. Aortic stenosis in the elderly: disease prevalence and number of candidates for transcatheter aortic valve replacement: a meta-analysis and modeling study. J Am Coll Cardiol. 2013; 62: 1002–1012. https://doi.org/10.1016/j. jacc.2013.05.015 PMID: 23727214

15. Faggiano P, Antonini-Canterin F, Baldessin F, Lorusso R, D’Aloia A, Cas LD. Epidemiology and cardiovascular risk factors of aortic stenosis. Cardiovasc Ultrasound. 2006; 4: 27. https://doi.org/10.1186/ 1476-7120-4-27 PMID: 16813661

16. Agarwal S, Rajamanickam A, Bajaj NS, Griffin BP, Catacutan T, Svensson LG, et al. Impact of aortic stenosis on postoperative outcomes after noncardiac surgeries. Circ Cardiovasc Qual Outcomes. 2013; 6: 193–200. https://doi.org/10.1161/CIRCOUTCOMES.111.000091 PMID: 23481524

17. Calleja AM, Dommaraju S, Gaddam R, Cha S, Khandheria BK, Chaliki HP. Cardiac risk in patients aged >75 years with asymptomatic, severe aortic stenosis undergoing noncardiac surgery. Am J Cardiol. 2010; 105: 1159–63. https://doi.org/10.1016/j.amjcard.2009.12.019 PMID: 20381670

18. Tashiro T, Pislaru SV, Blustin JM, Nkomo VT, Abel MD, Scott CG, et al. Perioperative risk of major noncardiac surgery in patients with severe aortic stenosis: a reappraisal in contemporary practice. Eur Heart J. 2014; 35: 2372–2381. https://doi.org/10.1093/eurheartj/ehu044 PMID: 24553722

19. Ehara S, Hasegawa T, Matsumoto K, Otsuka K, Yamazaki T, Iguchi T, et al. The strain pattern, and not Sokolow-Lyon electrocardiographic voltage criteria, is independently associated with anatomic left ventricular hypertrophy. Heart Vessels. 2014; 29: 638–644. https://doi.org/10.1007/s00380-013-0408-0 PMID: 24048761

20. Greve AM, Gerdts E, Boman K, Gohlke-Baerwolf C, RossebØ AB, Hammer-Hansen S, et al. Differences in cardiovascular risk profile between electrocardiographic hypertrophy versus strain in asymptomatic patients with aortic stenosis (from SEAS data). Am J Cardiol. 2011; 108: 541–547. https://doi. org/10.1016/j.amjcard.2011.03.084 PMID: 21624542

21. Greve AM, Boman K, Gohlke-Baerwolf C, Kesa¨niemi YA, Nienaber C, Ray S, et al. Clinical implications of electrocardiographic left ventricular strain and hypertrophy in asymptomatic patients with aortic stenosis: the Simvastatin and Ezetimibe in Aortic Stenosis study. Circulation. 2012; 125: 346–353. https:// doi.org/10.1161/CIRCULATIONAHA.111.049759 PMID: 22147903

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