Comparison of characteristics of patients with severe aortic stenosis in prior research projects
| IMPULSE11 | Euro Heart Survey7 13 | AVARIJN10 | CURRENT AS8 9 | |
| Years | 2015–2016 | 2001 | 2006–2009 | 2003–2011 |
| Location | Europe | Europe | The Netherlands | Japan |
| Number of centres | 23 (tertiary hospitals) | 92 (incl. outpatients and out of hospital) | 7 | 27 |
| Design | Prospective | Prospective | Prospective | Retrospective |
| Definition of severe AS | any of | any of | any of | any of |
| Vmax (m/s) | >4.0 | – | ≥4.0 | >4.0 |
| AVA (cm2) | <1.0 | – | ≤1.0 | <1.0 |
| AVA indexed (cm2/m2) | <0.6 | ≤0.6 | – | – |
| Mean pressure gradient (mm Hg) | >40 | ≥50 | – | >40 |
| AV/LVOT velocity time integral ratio | – | – | ≥4.0 | – |
| Patients with severe AS | 2171 | 800 | 191 | 3815 |
| Symptomatic (%) | 1743 (80.3) | 716 (89.5) | 132 (69.1) | 2005 (52.6) |
| Asymptomatic (%) | 428 (19.7) | 84 (10.5) | 59 (30.9) | 1808 (47.4) |
| Patient characteristics | ||||
| Age (years) | 77.9±10.0 | 69* | 72.6 (63.7–78.6) | 77.8±9.8 |
| Female (%) | 48.0 | 43.0 | 38 | 62 |
| Chronic lung disease (%) | 11.4 | 27.4 | 17 | 10 |
| Renal impairment severe (%) | 25.3 | – | – | 15 |
| Dialysis (%) | 2.0 | – | – | 11 |
| Atrial fibrillation (%) | 15.9 | 19.7 | – | 22 |
| Log EuroSCORE I (%) | 15.6±13.9 | – | 5.4 (3.1–8.2) | 9.7 (5.8–16.7) |
| STS score (%) | – | – | 4.5 (2.8–7.6) | 3.8 (2.2–6.5) |
| Echocardiography | ||||
| AVA (cm2) | 0.73±0.19 | 0.74* | 0.74 (0.59; 0.91) | 0.72±0.18 |
| Indexed AVA (cm2/m2) | 0.40±0.11 | 0.41* | – | 0.50±0.13 |
| Vmax (m/s) | 4.3±0.7 | – | 4.3±0.8 | 4.1±0.9 |
| Mean aortic transvalvular gradient (mm Hg) | 47.1±14.7 | 55* | – | 40.8±19.7 |
| LV EDD (mm) | 47.9±9.1 | 50.9* | – | 45.9±7.0 |
| LV ESD (mm) | 31.6±10.2 | 33.7* | – | 30.2±7.9 |
| LVH (%) | 62.1 | – | 27 | – |
| LVEF (%) | 55.8±12.1 | 57.5* | 61±7 | 62.8±13.5 |
| >50% | 72.6 | 67.3 | – | – |
| 30%–50% | 24.1 | 28.1 | – | – |
| <30% | 3.2 | 4.6 | – | – |
| Treatment decision | ||||
| TAVR (%) | 52.9 | 0 | 47.6† | 31.4† |
| SAVR (%) | 24.0 | 75.2 | ||
| Conservative management (%) | 31.1 | 24.8 | 52.4 | 68.6 |
*Approximations as numbers are only available for severe symptomatic and severe asymptomatic separately.
†TAVR and SAVR combined.
AS, aortic stenosis; AVA, aortic valve area; AVARIJN, Aortic VAlve RIJNmond; EDD, end-diastolic diameter; ESD, end-systolic diameter; LV, left ventricle; LVEF, left ventricular ejection fraction; LVH, left ventricular hypertrophy; LVOT, left ventricular outflow tract; SAVR, surgical aortic valve replacement; STS, Society of Thoracic Surgeons; TAVR, transcatheter aortic valve replacement; V max, maximum jet velocity