How Stable Are Patients with Moderate Aortic Stenosis and Left Ventricular Dysfunction?

A high rate of adverse events prompts the question of whether earlier intervention would improve outcomes.

The authors of this international, four-site study examined longitudinal outcomes data on 305 patients (mean age, 73; 75% men) who were identified on baseline echocardiograms with moderate aortic stenosis (AS; defined by aortic valve area [AVA] >1.0 and <1.5 cm²) and left ventricular (LV) dysfunction (ejection fraction, <50%).

Coronary artery disease was present in 72% of patients. On echocardiography, the mean ejection fraction was 38%, mean AVA was 1.24 cm², and mean transaortic gradient was 15 mm Hg. Dobutamine stress echocardiography was used in 11% of patients to exclude severe AS.

At 4 years of follow-up, 61% had a clinical event included in the primary composite endpoint: death (36%), heart-failure hospitalization (27%), or aortic valv…

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)