Evidence map›Paper›PMID 34426527›Full record

Trial reportOpen heart2021

Low myocardial energetic efficiency is associated with increased mortality in aortic stenosis.

Edda Bahlmann, Eigir Einarsen, Dana Cramariuc, Helga Midtbø, Costantino Mancusi, Anne Rossebø, Stephan Willems, Eva Gerdts

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Open heart, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00092677 (A Multicenter, Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Effects of Ezetimibe + Simvastatin on Clinical Outcomes in Patients With Aortic Stenosis), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00092677 phase3completednot on this map

A Multicenter, Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Effects of Ezetimibe + Simvastatin on Clinical Outcomes in Patients With Aortic Stenosis

TypeinterventionalSponsorOrganon and CoRan2001 to 2008Enrolled1,873ConditionsAortic StenosisArmsezetimibe (+) simvastatin, Comparator: Placebo
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Edda BahlmannDepartment of Cardiology, Asklepios Kliniken St. Georg, Hamburg, Germany doc_edda@hotmail.com.ORCID 0000-0002-4242-0535
Eigir EinarsenDepartment of Clinical Science, University of Bergen Department of Medicine, Bergen, Norway.ORCID 0000-0002-6672-3370
Dana CramariucDepartment of Clinical Science, University of Bergen Department of Medicine, Bergen, Norway.
Helga MidtbøDepartment of Heart Disease, Haukeland University Hospital Department of Heart Disease, Bergen, Norway.
Costantino MancusiDepartment of Advanced Biomedical Science and Hypertension Research Center, Federico II University of Naples, Naples, Italy.
Anne RossebøDepartment of Cardiology, Oslo University Hospital Ullevaal, Oslo, Norway.
Stephan WillemsDepartment of Cardiology, Asklepios Kliniken St. Georg, Hamburg, Germany.
Eva GerdtsDepartment of Clinical Science, University of Bergen Department of Medicine, Bergen, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIn hypertension, low myocardial energetic efficiency (MEEi) has been documented as an integrated marker of metabolic and left ventricular (LV) myocardial dysfunction. We tested the predictive performance of MEEi in initially asymptomatic aortic stenosis (AS) patients free from diabetes and known cardiovascular disease.

methodsData from 1703 patients with mostly moderate AS enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study followed for 4.3 years was used. MEE was calculated from Doppler stroke volume/([heart rate/60]) and indexed to LV mass (MEEi). The threshold value for MEEi associated with increased mortality was identified in generalised additive model with smoothing splines. Covariables of MEEi were identified in logistic regression analysis. Outcome was assessed in Cox regression analysis and reported as HR and 95% CI.

resultsMEEi <0.34 mL/s per gram was associated with increased cardiovascular mortality (n=80) (HR 2.53 (95% CI 1.50 to 4.28)) and all-cause mortality (n=155) (HR 1.74 (95% CI 1.20 to 2.52)) (both p<0.01). The association was independent of confounders of low MEEI (<0.34 mL/s per gram) identified in multivariable logistic regression analysis, including more severe AS, higher body mass index, lower LV midwall shortening and ejection fraction and presence of hypertension. Comparison of the Cox models with and without MEEi among the covariables demonstrated that MEEi significantly improved the prognostic yield (both p<0.01).

conclusionsIn patients with initially asymptomatic AS, low MEEi was associated with clustering of cardiometabolic risk factors, lower LV myocardial function and subsequent increased mortality during 4.3 years follow-up, independent of known prognosticators. TRIAL REGISTRATION NUMBER: NCT00092677.

Indexed as

AgedAnticholesteremic AgentsAortic ValveAortic Valve StenosisDouble-Blind MethodEchocardiography, DopplerEnergy MetabolismEuropeEzetimibeFollow-Up StudiesHumansMiddle AgedMyocardiumPrognosisProspective StudiesSimvastatinAnticholesteremic AgentsEzetimibeSimvastatinaortic valve stenosisechocardiographyhealth careoutcome assessment

Identifiers

PMID34426527
PMCPMC8383869

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.