PMID- 33607944
OWN - NLM
STAT- MEDLINE
DCOM- 20211004
LR  - 20211004
IS  - 1471-2261 (Electronic)
IS  - 1471-2261 (Linking)
VI  - 21
IP  - 1
DP  - 2021 Feb 19
TI  - Natural history observations in moderate aortic stenosis.
PG  - 108
LID - 10.1186/s12872-021-01901-1 [doi]
LID - 108
AB  - 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.
FAU - Du, Yu
AU  - Du Y
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
AD  - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, 
      Beijing, 100029, China.
FAU - Gossl, Mario
AU  - Gossl M
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Garcia, Santiago
AU  - Garcia S
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Enriquez-Sarano, Maurice
AU  - Enriquez-Sarano M
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Cavalcante, Joao L
AU  - Cavalcante JL
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Bae, Richard
AU  - Bae R
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Hashimoto, Go
AU  - Hashimoto G
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Fukui, Miho
AU  - Fukui M
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Lopes, Bernardo
AU  - Lopes B
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Ahmed, Aisha
AU  - Ahmed A
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Schmidt, Christian
AU  - Schmidt C
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Stanberry, Larissa
AU  - Stanberry L
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Garberich, Ross
AU  - Garberich R
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Bradley, Steven M
AU  - Bradley SM
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Steffen, Robert
AU  - Steffen R
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA.
FAU - Sorajja, Paul
AU  - Sorajja P
AUID- ORCID: 0000-0001-6401-854X
AD  - Roger L. and Lynn C. Headrick Chair, Valve Science Center, Minneapolis Heart 
      Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, 55407, USA. 
      paul.sorajja@allina.com.
LA  - eng
PT  - Journal Article
DEP - 20210219
PL  - England
TA  - BMC Cardiovasc Disord
JT  - BMC cardiovascular disorders
JID - 100968539
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/diagnostic imaging/physiopathology
MH  - Aortic Valve Stenosis/diagnostic imaging/*mortality/physiopathology/therapy
MH  - Comorbidity
MH  - Disease Progression
MH  - Echocardiography, Doppler
MH  - Female
MH  - Heart Failure/diagnostic imaging/*mortality/physiopathology/therapy
MH  - Hospitalization
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Progression-Free Survival
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Time Factors
MH  - Ventricular Dysfunction, Left/diagnostic 
      imaging/*mortality/physiopathology/therapy
MH  - Ventricular Function, Left
PMC - PMC7893941
OTO - NOTNLM
OT  - Aortic stenosis
OT  - Aortic valve replacement
OT  - Moderate
OT  - Outcomes
OT  - Survival
COIS- Dr. Gossl serves as a consultant for Abbott Structural. Dr. Garcia receives 
      Institutional Research grants from Edwards Lifesciences and Boston Scientific; 
      proctors Edwards Lifesciences. Dr. Sarano is a consultant for Cryolife inc, 
      Edwards Lifesciences LLC. Dr. Cavalcante serves as a consultant for Boston 
      Scientific, Abbott Vascular; a speaker for Medtronic, Circle Cardiovascular 
      Imaging, and Siemens Healthineers; receives research grant support from Circle 
      Cardiovascular Imaging, Edwards Lifesciences, Medtronic, Boston Scientific, and 
      Abbott Vascular. Dr. Bae is a consultant for Abbott Structural. Dr. Sorajja is a 
      consultant for Abbott Structural, Anteris, Boston Scientific, Edwards 
      Lifesciences, Medtronic, TeleFlex, WL Gore. The other authors report no conflict 
      of interest.
EDAT- 2021/02/21 06:00
MHDA- 2021/10/05 06:00
PMCR- 2021/02/19
CRDT- 2021/02/20 05:24
PHST- 2020/10/09 00:00 [received]
PHST- 2021/02/02 00:00 [accepted]
PHST- 2021/01/30 00:00 [revised]
PHST- 2021/02/20 05:24 [entrez]
PHST- 2021/02/21 06:00 [pubmed]
PHST- 2021/10/05 06:00 [medline]
PHST- 2021/02/19 00:00 [pmc-release]
AID - 10.1186/s12872-021-01901-1 [pii]
AID - 1901 [pii]
AID - 10.1186/s12872-021-01901-1 [doi]
PST - epublish
SO  - BMC Cardiovasc Disord. 2021 Feb 19;21(1):108. doi: 10.1186/s12872-021-01901-1.