Clinical factors associated with classical symptoms of aortic valve stenosis.

Yuji Nishizaki, Masao Daimon, Sakiko Miyazaki, Hiromasa Suzuki, Takayuki Kawata, Katsumi Miyauchi, Shuo Ju Chiang, Haruka Makinae, Tomohiro Shinozaki, Hiroyuki Daida

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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. The medical records of 170 consecutive patients with AS (> or = 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 > or = 2), angina, and syncope. 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 e' 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. 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.

Original languageEnglish
Pages (from-to)287-294
Number of pages8
JournalThe Journal of heart valve disease
Volume22
Issue number3
Publication statusPublished - May 2013
Externally publishedYes

Fingerprint

Aortic Valve Stenosis
Dyspnea
Syncope
Coronary Stenosis
Aortic Valve
Coronary Angiography
Medical Records
Pathologic Constriction
Logistic Models
Hemodynamics
Regression Analysis
Hypertension
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Nishizaki, Y., Daimon, M., Miyazaki, S., Suzuki, H., Kawata, T., Miyauchi, K., ... Daida, H. (2013). Clinical factors associated with classical symptoms of aortic valve stenosis. The Journal of heart valve disease, 22(3), 287-294.

Clinical factors associated with classical symptoms of aortic valve stenosis. / Nishizaki, Yuji; Daimon, Masao; Miyazaki, Sakiko; Suzuki, Hiromasa; Kawata, Takayuki; Miyauchi, Katsumi; Chiang, Shuo Ju; Makinae, Haruka; Shinozaki, Tomohiro; Daida, Hiroyuki.

In: The Journal of heart valve disease, Vol. 22, No. 3, 05.2013, p. 287-294.

Research output: Contribution to journalArticle

Nishizaki, Y, Daimon, M, Miyazaki, S, Suzuki, H, Kawata, T, Miyauchi, K, Chiang, SJ, Makinae, H, Shinozaki, T & Daida, H 2013, 'Clinical factors associated with classical symptoms of aortic valve stenosis.', The Journal of heart valve disease, vol. 22, no. 3, pp. 287-294.
Nishizaki Y, Daimon M, Miyazaki S, Suzuki H, Kawata T, Miyauchi K et al. Clinical factors associated with classical symptoms of aortic valve stenosis. The Journal of heart valve disease. 2013 May;22(3):287-294.
Nishizaki, Yuji ; Daimon, Masao ; Miyazaki, Sakiko ; Suzuki, Hiromasa ; Kawata, Takayuki ; Miyauchi, Katsumi ; Chiang, Shuo Ju ; Makinae, Haruka ; Shinozaki, Tomohiro ; Daida, Hiroyuki. / Clinical factors associated with classical symptoms of aortic valve stenosis. In: The Journal of heart valve disease. 2013 ; Vol. 22, No. 3. pp. 287-294.
@article{3a2a9f7fe2654123a8318e522db74277,
title = "Clinical factors associated with classical symptoms of aortic valve stenosis.",
abstract = "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. The medical records of 170 consecutive patients with AS (> or = 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 > or = 2), angina, and syncope. 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 e' 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. 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.",
author = "Yuji Nishizaki and Masao Daimon and Sakiko Miyazaki and Hiromasa Suzuki and Takayuki Kawata and Katsumi Miyauchi and Chiang, {Shuo Ju} and Haruka Makinae and Tomohiro Shinozaki and Hiroyuki Daida",
year = "2013",
month = "5",
language = "English",
volume = "22",
pages = "287--294",
journal = "Journal of Heart Valve Disease",
issn = "0966-8519",
publisher = "ICR Publishers Ltd",
number = "3",

}

TY - JOUR

T1 - Clinical factors associated with classical symptoms of aortic valve stenosis.

AU - Nishizaki, Yuji

AU - Daimon, Masao

AU - Miyazaki, Sakiko

AU - Suzuki, Hiromasa

AU - Kawata, Takayuki

AU - Miyauchi, Katsumi

AU - Chiang, Shuo Ju

AU - Makinae, Haruka

AU - Shinozaki, Tomohiro

AU - Daida, Hiroyuki

PY - 2013/5

Y1 - 2013/5

N2 - 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. The medical records of 170 consecutive patients with AS (> or = 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 > or = 2), angina, and syncope. 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 e' 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. 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.

AB - 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. The medical records of 170 consecutive patients with AS (> or = 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 > or = 2), angina, and syncope. 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 e' 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. 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.

UR - http://www.scopus.com/inward/record.url?scp=84891539619&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84891539619&partnerID=8YFLogxK

M3 - Article

C2 - 24151753

AN - SCOPUS:84891539619

VL - 22

SP - 287

EP - 294

JO - Journal of Heart Valve Disease

JF - Journal of Heart Valve Disease

SN - 0966-8519

IS - 3

ER -