Valvular Heart DiseasePrevalence and Prognostic Impact of Valve Area—Gradient Patterns in Patients ≥80 Years With Moderate-to-Severe Aortic Stenosis (from the Prospective BELFRAIL Study)
Section snippets
Methods
The BFC80+ study is a prospective, observational, population-based cohort study of subjects ≥80 years in 3 well-circumscribed areas of Belgium. The study design and characteristics of the cohort have been described in detail elsewhere.4, 5 From November 2, 2008, to September 15, 2009, 567 subjects were included in the BFC80 + study. Of these patients, 25 subjects were excluded from the present analysis, 11 because of lack of baseline echocardiographic data and 14 because of previous aortic
Results
The baseline clinical, hemodynamic, and echocardiographic characteristics of the study population are listed in Tables 1 and 2. Moderate-to-severe AS was found in 80 of 542 patients (14.7%), of whom 32 had severe AS (5.9%) and 48 had moderate AS (9.0%). In patients with severe AS, paradoxical LG-AS was more prevalent than HG-AS (23 of 32 vs 9 of 32). Compared with patients with no or mild AS, those with severe AS were older, more frequently experienced NYHA class III-IV symptoms, more often
Discussion
The present study found that, of patients ≥80 years, the prevalence of moderate-to-severe AS was 14.7% and that of severe AS, 5.9%. In patients with severe AS, the majority (72%) exhibited the paradoxical LG form of severe AS, whereas the remaining 28% presented with severe HG-AS. Interestingly, all the patients with severe HG-AS were asymptomatic at the time of inclusion into the study, which contrasted with the situation in patients with severe paradoxical LG-AS, who often presented with
Disclosures
The authors have no conflicts of interest to disclose.
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Cited by (16)
Low-Flow, Low-Gradient Severe Aortic Stenosis in patients with preserved or reduced ejection fraction: a systematic literature review.
2024, Current Problems in CardiologyImpact of Moderate Aortic Stenosis on Long-Term Clinical Outcomes: A Systematic Review and Meta-Analysis
2022, JACC: Cardiovascular InterventionsCitation Excerpt :A total of 277,041 patients from 8 studies7,8,18,19,21,22,38,40 with a mean follow-up of 3.7 ± 1.7 years were included in the meta-analysis comparing the all-cause mortality of patients with no or mild versus moderate AS. A total of 13,848 patients from 11 studies6-8,18,19,21,24,25,27,28,41 with a mean follow-up of 3.8 ± 1.7 years were included in the meta-analysis comparing the all-cause mortality of patients with severe versus moderate AS. The rate of all-cause death was 9.0 (95% CI: 6.9 to 11.7; I2 = 97%) per 100 person-years (Figure 1A).
Integration of Flow-Gradient Patterns Into Clinical Decision Making for Patients With Suspected Severe Aortic Stenosis and Preserved LVEF: A Systematic Review of Evidence and Meta-Analysis
2016, JACC: Cardiovascular ImagingCitation Excerpt :Also, there are reports of LFLG SAS patients whose test results show an increase in transaortic gradients over time which is not consistent with the notion that LFLG SAS is the “burnt-out” stage of SAS (28). Other studies have suggested that LFLG SAS carries outcomes similar to moderate aortic stenosis (10,30). While our study showed a significant difference in the natural history of LG SAS based on the estimation of the SVI, a high degree of heterogeneity was observed in all analyses.
Changes in echocardiographic parameters over time in paradoxical low-flow low-gradient aortic stenosis
2023, European Heart Journal Cardiovascular ImagingPrognosis of Paradoxical Low-Flow Low-Gradient Aortic Stenosis: A Severe, Non-critical Form, With Surgical Treatment Benefits
2022, Frontiers in Cardiovascular Medicine
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