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Association of Non-Severe Aortic Stenosis With Left Ventricular Reverse Remodeling and Clinical Outcomes After

Masaki Ishiyama1, Naoki Fujimoto1, Tetsuji Kitano1

  • 1Department of Cardiology and Nephrology, Mie University Graduate School of Medicine Mie Japan.

Circulation Reports
|August 11, 2026
PubMed

Insights

Non-severe aortic stenosis (AS) impairs cardiac resynchronization therapy (CRT) response, leading to less left ventricular (LV) reverse remodeling and worse long-term outcomes in heart failure patients.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Aortic Stenosis Studies

Background:

  • The impact of non-severe aortic stenosis (AS) on cardiac resynchronization therapy (CRT) effectiveness is not well understood.
  • Investigating non-severe AS in heart failure patients undergoing CRT is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To determine if non-severe AS influences left ventricular (LV) reverse remodeling after CRT.
  • To assess the effect of non-severe AS on long-term clinical outcomes in patients receiving CRT.

Main Methods:

  • Retrospective analysis of 181 chronic heart failure patients who received CRT.
  • Patients were categorized into non-severe AS (mild/moderate) and no AS groups.
  • Primary endpoint: composite of all-cause death/heart failure hospitalization; Secondary endpoint: LV reverse remodeling (≥15% LV end-systolic volume reduction at 6 months).

Main Results:

  • Non-severe AS patients were older with higher baseline LV ejection fraction.
  • LV reverse remodeling was less frequent in the non-severe AS group (39% vs. 66%, P<0.05).
  • Non-severe AS independently predicted lower likelihood of LV reverse remodeling and adverse outcomes (HR 2.19, P=0.01) during 3.5-year follow-up.

Conclusions:

  • Non-severe aortic stenosis is linked to reduced left ventricular reverse remodeling following CRT.
  • Patients with non-severe AS experience poorer long-term outcomes after CRT.
  • Non-severe AS may act as a significant factor modifying the response to CRT.
Abstract

Keywords:
Aortic stenosisCardiac resynchronization therapyHeart failureReverse remodeling

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