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Long Term Clinical Outcomes in Patients with Moderate Aortic Stenosis

Han Joon Bae1, Jongmin Hwang1, Seongwook Han1

  • 1Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.

The Heart Surgery Forum
|June 12, 2020
PubMed

Insights

Symptomatic patients with moderate aortic stenosis (AS) face higher risks than expected. Early intervention is recommended for those with diabetes mellitus (DM) and mitral regurgitation (MR).

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Medical Research

Background:

  • Current guidelines suggest watchful waiting for moderate aortic stenosis (AS).
  • Clinical outcomes for moderate AS with comorbidities are not well-studied.
  • This study investigates factors influencing moderate AS outcomes over five years.

Purpose of the Study:

  • To explore factors contributing to adverse outcomes in moderate AS patients.
  • To evaluate the 5-year composite endpoint of cardiovascular death, heart failure aggravation, or aortic valve replacement.
  • To identify predictors of poor outcomes in this patient cohort.

Main Methods:

  • Retrospective review of 148 moderate AS patients (2008-2012).
  • Gathering of echocardiographic data and 5-year clinical outcomes.
  • Multivariate analysis to identify independent predictors of adverse events.

Main Results:

  • 79 out of 148 patients experienced adverse outcomes over a mean follow-up of 5.6 years.
  • Diabetes mellitus (DM), moderate-to-severe mitral regurgitation (MR), and NYHA class III-IV dyspnea were independently associated with adverse outcomes.
  • Worse symptoms, higher DM and MR rates, and smaller aortic valve areas were observed in the adverse event group.

Conclusions:

  • Symptomatic moderate AS patients have a higher event rate than anticipated.
  • Early intervention should be considered for moderate AS patients with concurrent MR and DM.
  • Identifying high-risk patients with moderate AS is crucial for timely management decisions.
Abstract

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