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Staging Cardiac Damage in Patients With Symptomatic Aortic Valve Stenosis
E Mara Vollema1, Mohammed R Amanullah2, Arnold C T Ng3
1Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
Journal of the American College of Cardiology
|July 27, 2019
Summary
A new staging system for severe aortic stenosis (AS) shows cardiac damage impacts mortality. Advanced stages (3 and 4) of AS-related cardiac injury significantly increase mortality risk in patients.
Area of Science:
- Cardiology
- Valvular Heart Disease
- Echocardiography
Background:
- Severe aortic stenosis (AS) frequently involves damage to structures beyond the aortic valve.
- A novel staging system has been proposed to categorize AS based on the extent of cardiac damage.
Purpose of the Study:
- To assess the prevalence and prognostic significance of a new cardiac damage staging system in symptomatic severe AS patients.
- To evaluate the association between different stages of cardiac damage and patient outcomes in a real-world setting.
Main Methods:
- Retrospective analysis of 1,189 symptomatic severe AS patients from multicenter registries.
- Classification of patients into five stages (0-4) based on echocardiographic evidence of cardiac damage.
- Follow-up for all-cause mortality and a combined endpoint including mortality, stroke, and cardiac hospitalization.
Main Results:
- The distribution of stages was: Stage 0 (8%), Stage 1 (24%), Stage 2 (49%), Stage 3 (7%), and Stage 4 (12%).
- Cardiac damage, particularly Stages 3 and 4, was independently associated with increased all-cause mortality and the combined endpoint.
Conclusions:
- The novel staging system effectively categorizes cardiac damage in severe AS.
- Advanced stages of cardiac injury (Stage 3 and 4) are significant independent predictors of mortality and adverse outcomes in symptomatic severe AS.
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