{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T07:10:18Z","timestamp":1781248218181,"version":"3.54.1"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,12,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The ratio of acceleration time\/ejection time (AT\/ET) is a simple and reproducible echocardiographic parameter that integrates aortic stenosis severity and its consequences on the left ventricle. No study has specifically assessed the prognostic impact of AT\/ET on outcome in patients with high\u2010gradient severe aortic stenosis (SAS) and no or mild symptoms. We sought to evaluate the relationship between AT\/ET and mortality and determine the best predictive AT\/ET cutoff value in these patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 353 patients (median age, 79\u00a0years; 46% women) with high\u2010gradient (mean pressure gradient \u226540\u00a0mm\u00a0Hg and\/or aortic peak jet velocity \u22654\u00a0m\/s) SAS, left ventricular ejection fraction \u226550%, and no or mild symptoms were studied. The impact of AT\/ET \u22640.35 or &gt;0.35 on all\u2010cause mortality was retrospectively studied. During a median follow\u2010up of 39 (25th\u201375th percentile, 23\u201362) months, 70 patients died. AT\/ET &gt;0.35 was associated with a considerable increased mortality risk after adjustment for established prognostic factors in SAS under medical and\/or surgical management (adjusted hazard ratio [HR], 2.54; 95% CI, 1.47\u20134.37;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) or conservative management (adjusted HR, 3.29; 95% CI, 1.70\u20136.39;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Moreover, AT\/ET &gt;0.35 improved the predictive performance of models including established risk factors in SAS with better global model fit, reclassification, and discrimination. After propensity matching, increased mortality risk persisted when AT\/ET &gt;0.35 (adjusted HR, 2.10; 95% CI, 1.12\u20133.90;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">AT\/ET &gt;0.35 is a strong predictor of outcome in patients with SAS and no or only mild symptoms and identifies a subgroup of patients at higher risk of death who may derive benefit from earlier aortic valve replacement.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.021873","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T19:02:15Z","timestamp":1638298935000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Relationship Between the Ratio of Acceleration Time\/Ejection Time and Mortality in Patients With High\u2010Gradient Severe Aortic Stenosis"],"prefix":"10.1161","volume":"10","author":[{"given":"Alexandre","family":"Altes","sequence":"first","affiliation":[{"name":"Cardiology Department Lille Catholic Hospitals Heart Valve Center Lille Catholic University Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Thellier","sequence":"additional","affiliation":[{"name":"Cardiology Department Lille Catholic Hospitals Heart Valve Center Lille Catholic University Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohann","family":"Bohbot","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire d\u2019Amiens Amiens France"},{"name":"EA 7517 MP3CV Jules Verne University of Picardie Amiens France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Ringle Griguer","sequence":"additional","affiliation":[{"name":"Cardiology Department Lille Catholic Hospitals 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