RT Journal Article
SR Electronic
T1 Symptoms, disease severity and treatment of adults with a new diagnosis of severe aortic stenosis
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1709
OP 1716
DO 10.1136/heartjnl-2019-314940
VO 105
IS 22
A1 Norbert Frey
A1 Richard Paul Steeds
A1 Tanja K Rudolph
A1 Jeetendra Thambyrajah
A1 Antonio Serra
A1 Eberhard Schulz
A1 Jiri Maly
A1 Marco Aiello
A1 Guy Lloyd
A1 Alessandro Santo Bortone
A1 Karl Eugen Hauptmann
A1 Alberto Clerici
A1 Georg Delle Karth
A1 Johannes Rieber
A1 Ciro Indorfi
A1 Massimo Mancone
A1 Loic Belle
A1 Alexander Lauten
A1 Martin Arnold
A1 Berto J Bouma
A1 Matthias Lutz
A1 Christiane Pohlmann
A1 Jana Kurucova
A1 Martin Thoenes
A1 Peter Bramlage
A1 David Messika-Zeitoun
A1 ,
YR 2019
UL http://heart.bmj.com/content/105/22/1709.abstract
AB Objective Contemporary data on patients with previously undiagnosed severe aortic stenosis (AS) are scarce. We aimed to address this gap by gathering data from consecutive patients diagnosed with severe AS on echocardiography.Methods This was a prospective, multicentre, multinational, registry in 23 tertiary care hospitals across 9 European countries. Patients with a diagnosis of severe AS were included using echocardiography (aortic valve area (AVA) <1 cm2, indexed AVA <0.6 cm2/m2, maximum jet-velocity (Vmax) >4 m/s and/or mean transvalvular gradient >40 mm Hg).Results The 2171 participants had a mean age of 77.9 years and 48.0% were female. The mean AVA was 0.73 cm2, Vmax4.3 m/s and mean gradient 47.1 mm Hg; 62.1% had left ventricular hypertrophy and 27.3% an ejection fraction (EF) <50%. 1743 patients (80.3%) were symptomatic (shortness-of-breath 91.0%; dizziness 30.2%, chest pain 28.9%). Patients had a EuroSCORE II of 4.0; 25.3% had a creatinine clearance <50 mL/min, and 3.2% had an EF <30%. Symptomatic patients were older and had more comorbidities than asymptomatic patients. Despite European Society of Cardiology 2017 valvular heart disease guideline class I recommendation, in only 76.2% a decision was made for an intervention (transcatheter 50.4%, surgical aortic valve replacement 25.8%). In asymptomatic patients, 57.7% with a class I/IIa indication were scheduled for a procedure, while 36.3% patients without an indication had their valve replaced.Conclusions The majority of patients with severe AS presented at an advanced disease stage. Management of severe AS remained suboptimal in a significant proportion of contemporary patients with severe AS.Trial registration number NCT02241447;Results.