Impact Of Obesity On Grading Of Aortic Stenosis (A Seas Substudy)

Background: We hypothesized that the disproportionate increase of body surface area (BSA) in obesity may lead to overestimation of aortic valve stenosis (AS) severity when the indexed valve area is used. Methods: Baseline data from 1524 patients enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study were used to calculate aortic valve area (AVA) and pressure recovery adjusted AVA (energy loss [EL]) and their indexed values (AVAI and ELI). Obesity was defined as body mass index (BMI) ≥30 kg/m2. Results: Peak aortic jet velocity, mean aortic gradient, AVA and EL did not differ between obese (n=321) and non-obese (n=1203) patient groups. A total of 225 patients had non-severe AS by AVA (>1.0 cm2), but severe AS by AVAI ( 1.0 cm2), but severe by ELI (<0.6 cm2/m2) (ELI/EL inconsistency). Compared to non-obese patients, more obese patients (23% vs. 13%) had AVAI/AVA inconsistency (p<0.01) (Fig.1). Adjustment for ...