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Cardiac Damage Stages and Clinical Outcomes in Patients With Severe Aortic Stenosis

Yasuaki Takeji1, Tomohiko Taniguchi2, Takeshi Morimoto3

  • 1Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan; Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

JACC. Advances
|August 27, 2025
PubMed

Insights

Cardiac damage staging effectively predicts outcomes in severe aortic stenosis (AS), regardless of gradient patterns or symptoms. Advanced stages significantly increase risks for death or heart failure hospitalization in both high-gradient and low-gradient AS.

Area of Science:

  • Cardiology
  • Clinical Outcomes Research
  • Aortic Stenosis

Background:

  • Prognostic impact of cardiac damage staging in severe aortic stenosis (AS) is not well understood.
  • Understanding cardiac damage in AS is crucial for patient stratification and treatment planning.

Purpose of the Study:

  • To assess differences in characteristics and clinical outcomes of AS patients based on cardiac damage stage.
  • To stratify AS patients by gradient patterns, symptoms, and treatment strategies.

Main Methods:

  • Included 3,369 patients with severe AS (high-gradient [HG] AS, n=1986; low-gradient [LG] AS, n=1383) from the CURRENT AS registry-2.
  • Categorized cardiac damage into 4 groups (stage 0, 1, 2, and 3/4).

Main Results:

  • Cumulative incidence of all-cause death or heart failure hospitalization increased with advancing cardiac damage stages in both HG and LG AS.
  • Adjusted HRs for stages 1, 2, and 3/4 vs stage 0 were significantly higher in both HG and LG cohorts.
  • Increased risk associated with cardiac damage was consistent regardless of symptoms or initial treatment strategies.

Conclusions:

  • Cardiac damage staging is a valuable tool for prognostic stratification in severe AS.
  • This staging is independent of gradient patterns, symptoms, and initial treatment strategies.
  • Prognostic stratification aids in personalized management of severe AS patients.
Abstract

Keywords:
aortic stenosisaortic valve replacementcardiac damage

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