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Prognostic impact of aortic valve area in conservatively managed patients with asymptomatic severe aortic stenosis with preserved ejection fraction

Journal of the American Heart Association Feb 08, 2019

Kanamori N, et al. - Researchers investigated the prognostic impact of aortic valve area (AVA) in 1,309 conservatively managed asymptomatic patients with severe aortic stenosis (AS) and left ventricular ejection fraction ≥50% in the CURRENT AS (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis) registry. According to AVA, the participants were classified into three groups (group 1: AVA >0.80 cm2, N=645; group 2: 0.8 cm2 ≥AVA >0.6 cm2, N=465; and group 3: AVA ≤0.6 cm2, N=199). The primary outcome measure was a composite of aortic valve-related death or heart failure hospitalization. Findings revealed incrementally higher cumulative 5-year incidence of the primary outcome measure with decreasing AVA (24.1%, 29.1%, and 48.1%). Overall, for the detection of those high-risk patients with asymptomatic severe AS who could benefit from early AVR, AVA ≤0.6 cm2 showed potential utility as a marker.

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