Predicting Outcome in Patients with Asymptomatic Aortic Stenosis

A simple risk score could take some of the uncertainty out of watchful waiting for valve replacement.

Predicting the outcome of severe but asymptomatic aortic stenosis (AS) is difficult. In this study, investigators in France prospectively followed 104 asymptomatic patients with moderate or severe AS, defined by a peak aortic-jet velocity of ≥3.0 meters/second, aortic valve area ≤1.5 cm², or both. During 24-month follow-up, three patients died and 59 required surgical valve replacement because of symptoms (in 58) or a positive stress test result (in 1). Based on these outcomes, the researchers developed a risk score, which was then validated in a separate group of 107 asymptomatic AS patients in Belgium.

In the initial cohort, three variables independently predicted death or valve replacement: female sex, serum B-type natriuretic peptide lev…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)