Natural history observations in moderate aortic stenosis.
BMC Cardiovasc Disord
; 21(1): 108, 2021 02 19.
Article
en En
| MEDLINE
| ID: mdl-33607944
ABSTRACT
BACKGROUND:
The natural history of patients with moderate aortic stenosis (AS) is poorly understood. We aimed to determine the long-term outcomes of patients with moderate AS.METHODS:
We examined patients with moderate AS defined by echocardiography in our healthcare system, and performed survival analyses for occurrence of death, heart failure (HF) hospitalization, and progression of AS, with accounting for symptoms, left ventricular dysfunction, and comorbidities.RESULTS:
We examined 729 patients with moderate AS (median age, 76 years; 59.9 % men) with a median follow-up of 5.0 years (interquartile range 2.0 to 8.1 years). The 5-year overall survival was 52.3 % (95 % confidence interval [CI] 48.6 % to 56.0 %) and survival free of death or HF hospitalization was 43.2 % (95 % CI 39.5 % to 46.9 %). Worse New York Heart Association (NYHA) functional class was associated with poor long-term survival, with mortality rates ranging from 7.9 % (95 % CI 6.6-9.2 %) to 25.2 % (95 % CI 20.2-30.3 %) per year. Among patients with minimal or no symptoms, no futility markers, and preserved left ventricular function, 5-year overall survival was 71.9 % (95 % CI 66.4-77.4 %) and survival free of death or HF hospitalization was 61.4 % (95 % CI 55.5-67.3 %). Risk factors associated with adverse events were age, NYHA class, low ejection fraction and high aortic valve velocity (all p < 0.05).CONCLUSIONS:
Patients with moderate AS are at significant risk of death. Our findings highlight the need for more study into appropriate therapeutic interventions to improve the prognosis of these patients.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Estenosis de la Válvula Aórtica
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Disfunción Ventricular Izquierda
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Insuficiencia Cardíaca
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
BMC Cardiovasc Disord
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos