Serial Echos Valuable in Patients with Asymptomatic Severe Aortic Stenosis

By Kelly Young

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Patients with asymptomatic severe aortic stenosis who don't get regular evaluations are at increased risk for death and heart failure, according to a retrospective study in JAMA Cardiology.

Researchers reviewed the records of 300 adults with asymptomatic severe aortic stenosis and preserved left ventricular function. Two thirds were adherent to guidelines recommending serial evaluation (including history, physical exam, and echocardiogram) every 6–12 months. During a median follow-up of 4.5 years, patients who didn't follow the guidelines had higher rates of mortality and admission for heart failure decompensation. Nonadherent patients also had lower rates of aortic valve replacement (19% vs. 54%).

The authors conclude: "Close monitoring of patients with asymptomatic severe aortic stenosis is warranted, and the current guidelines of serial evaluations performed annually are beneficial. More initiatives to promote guideline adherence are warranted, with the ultimate goal of timely intervention for patients who may benefit from aortic valve replacement."