Abstract 13976: Upstroke Time per Cardiac Cycle: Screening Index for Severe Aortic Stenosis

Introduction: AS is one of the most common valvular heart diseases in the elderly population. Since the TAVR era, the indications for AS invasive treatment have expanded to patients at high risk of surgery and even those at moderate risk. Therefore, a simplified screening test is needed to extract patients with severe AS. Hypothesis: Brachial-ankle pulse wave analysis, which is a non-invasive well-established test, is useful for screening patients with severe AS in routine clinical practice. Methods: We recruited patients who were admitted to Hiroshima University Hospital for scrutiny of AS. Severe AS was defined as an aortic valve area (AVA) of <1.0 cm 2 or peak transaortic velocity >4 m/s or a mean pressure gradient of >40 mmHg. Pulse wave measurement was performed with the VP-1000 device (Omron, Kyoto, Japan), and upstroke time per cardiac cycle (UTCC; [upstroke time/cardiac cycle] x 100%) was calculated. We excluded patients with peripheral artery disease (ABI <0.9) or lack of UTCC data. Results: A total of 235 patients with AVA and UTCC available data were analyzed. In these patients, UTCC was correlated with AVA (r = -0.279; p <0.001, Figure). In 121 patients who underwent TAVR and had available data of UTCC before and after TAVR, UTCC was significantly shortened after TAVR (from 20.7% [IQR; 18.6, 23.3] to 18.7% [16.7, 21.0]; p <0.001). After adjustment by LVEF, LVEDV, BSA, and AF, UTCC was still correlated with AVA (β= -0.012, p = 0.001). Conclusions: UTCC from brachial-ankle pulse wave analysis might help identify severe AS patients in routine clinical practice.