Derivation of a Size-Independent Variable for Scaling of Cardiac Dimensions in a Normal Adult Population

Neilan, Tomas G.; Pradhan, Aruna D.; Weyman, Arthur E.

doi:10.1016/j.echo.2007.12.003

Cited by 35 publications

(51 citation statements)

References 24 publications

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“…Second, alternative formulae for the assessment of BSA exist, however calculation of BSA based on work by Dubois and Dubois17 did not change results significantly (data not shown). Third, the validity of linear adjustment of cardiac dimensions by BSA has been questioned18 and stratification of patients according to quartiles of BSA may therefore be an oversimplification with respect to the relationship between AVA and body size. Forth, overweight status may be a limitation of AVA index ,14 since BSA corrects not only for individual body size but also for acquired fat tissue.…”

Section: Discussionmentioning

confidence: 99%

Indexing aortic valve area by body surface area increases the prevalence of severe aortic stenosis

Jander

Gohlke-Bärwolf

Bahlmann

et al. 2013

Heart

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Background To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVA index ). Cut-off values for severe stenosis are <1.0 cm 2 for AVA and <0.6 cm 2 /m 2 for AVA index . Objective To investigate the influence of indexation on the prevalence of severe aortic stenosis and on the predictive accuracy regarding clinical outcome. Methods Echocardiographic and anthropometric data from a retrospective cohort of 2843 patients with aortic stenosis ( jet velocity >2.5 m/s) and from 1525 patients prospectively followed in the simvastatin and ezetimibe in aortic stenosis (SEAS) trial were analysed. Results The prevalence of severe stenosis increased with the AVA index criterion compared to AVA from 71% to 80% in the retrospective cohort, and from 29% to 44% in SEAS (both p<0.001). Overall, the predictive accuracy for aortic valve events was virtually identical for AVA and AVA index in the SEAS population (mean follow-up of 46 months; area under the receiver operating characteristic curve: 0.67 (95% CI 0.64 to 0.70) vs 0.68 (CI 0.65 to 0.71) (NS). However, 213 patients additionally categorised as severe by AVA index experienced significantly less valve related events than those fulfilling only the AVA criterion ( p<0.001). Conclusions Indexing AVA by BSA (AVA index ) significantly increases the prevalence of patients with criteria for severe stenosis by including patients with a milder degree of the disease without improving the predictive accuracy for aortic valve related events.

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Section: Discussionmentioning

confidence: 99%

Indexing aortic valve area by body surface area increases the prevalence of severe aortic stenosis

Jander

Gohlke-Bärwolf

Bahlmann

et al. 2013

Heart

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“…[26][27][28][29][30] As for obesity, left ventricular hypertrophy, 31,32 increased total blood volume, 33 clusters of metabolic syndrome 7,34 and obstructive sleep apnea 9,35 have been proposed as plausible mechanisms for an increase in LA volume. In contrast, for height the mechanism of its strong relationship to LAD [28][29][30] could be explained by the association with the thoracic size, 36 which would physically affect the primary size of the LA.…”

Section: Relationship Between Body Size and Ladmentioning

confidence: 99%

Body Size and Atrial Fibrillation in Japanese Outpatients

Suzuki

Yamashita

Ohtsuka

et al. 2010

Circ J

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“…Since adjustment by any parameter should ideally eliminate the correlation of the variable under consideration with that parameter, the resulting Pearson correlation coefficient should be zero. Allometric modelling was performed using non-linear regression based on the equation y=a×x b 4. Time-to-event adjusted receiver operating characteristic (ROC) curves were constructed to compare the ability of parameters of aortic valve stenosis (jet velocity, MPG and AVA adjusted by the different measures of body size) to predict aortic valve events or cardiovascular death.…”

Section: Methodsmentioning

confidence: 99%

“…Adjusting AVA appears intuitively convincing, should improve comparability between patient populations, and has been widely adopted in the literature. However, scientific data to support this approach are scarce4 and a number of reports have questioned the validity of linear adjustment or scaling of cardiac dimensions by measures of body size both based on theoretic and mathematic considerations and rather support a non-linear (allometric) approach 4–8. To our knowledge, adjustment of AVA by body size in adults has so far only been systematically investigated in a single cohort of healthy volunteers9 and little information regarding adjustment in patients with aortic valve stenosis is available.…”

Section: Introductionmentioning

confidence: 99%