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Isk factors were collected from a local database at the Department of Cardiology and the Department of Cardiothoracic Surgery, GentofteEchocardiography was performed using Vivid 7 or Vivid E9 (General Electric Healthcare, Horten, Norway) between December 2005 and December 2010 and analyzed de novo by one person blinded to clinical information using EchoPAC PC version 108.1.12 (General Electric Healthcare, Horten, Norway). Most patients had more than one examination in the database. To ensure early inclusion and long follow-up the first digitally stored examination was PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/13485127 included. Severity of AS were graded in mild, moderate and severe AS in agreement with current guidelines [15]. Maximum pressure gradient was calculated from the maximum jet velocity across the aortic valve and the left ventricular outflow tract (LVOT) PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/21715270 using the modified Bernoulli 2,2,3,3-Tetrafluoropropyl N,N'-diethylcarbamimidothioate trifluoromethanesulfonate equation. LVOT diameter was measured in mid-systole from the parasternal long-axis view. Aortic Valve Methyl 2-((4-nitro-1h-pyrazol-1-yl)methyl)benzoate Area (AVA) was calculated by the continuity equation [15]. Mild degrees of mitral and aortic regurgitation were evaluated using multiple views of color flow imaging measuring the origin, direction and size of the regurgitation jet. In suspicion of moderate or severe regurgitation; vena contracta width, pressure half-time (for aortic regurgitation) and if possible also regurgitant volume was calculated [16,17]. Heart rate was averaged from 15 heart cycles in AFib and 7 heart cycles in SR. To optimize echocardiographic assessment of LV function and to reduce the influence of beat-to-beat variation in AFib, means from two or more heart cycles were used. LV dimensions were estimated from the parasternal long-axis view. LV mass was calculated using the Devereux formula [18] and indexed to BSA. The LV enddiastolic and end-systolic volumes and left ventricular ejection fraction (LVEF) were estimated using Simpson's method in the apical four- and two-chamber view. Endsystolic left atrial volume was calculated using the arealength method in the apical four- and two-chamber view. Trans-mitral Early inflow (E) and Deceleration Time were obtained from pulsed wave Doppler in the apical four-chamber view. Pulmonary valve jet velocity was obtained using continuous wave Doppler from the parasternal short-axis view. Tricuspid valve regurgitation velocity was obtained using continuous wave Doppler from a modified apical four-chamber-view optimized for the right-sided chambers. Peak gradients for pulmonary valve and tricuspid valve regurgitation were calculated using the Bernoulli equation [15]. Right atrial pressure was estimated as normal (3 mmHg), intermediate (8 mmHg)Burup Kristensen et al. Cardiovascular Ultrasound 2012, 10:38 http://www.cardiovascularultrasound.com/content/10/1/Page 3 ofand high (15 mmHg) from size and inspiratory response of the inferior vena cava in the subxiphoidal view [19]. Systolic pulmonary artery pressure was determined by adding the tricuspid valve regurgitation gradient and the estimated right atrial pressure. Peak early diastolic longitudinal mitral annular velocity (e') was measured using pulsed wave tissue Doppler in the lateral mitral annulus in the apical four-chamber view. Iso-volumetric relaxation time were calculated using tissue Doppler M-mode of the anterior mitral leaflet in the apical four-chamberview [20].Operative risk calculationgroups: when removing the influence of LV dysfunction from EuroSCORE, there were no significant differences between cases and controls (Table.