Mild and moderate aortic stenosis: Natural history and risk stratification by echocardiography
To define the natural history and predictors of outcome in mild and moderate aortic stenosis (AS). One hundred and seventy-six consecutive asymptomatic patients (73 women, age 58+/-19 years) with mild to moderate AS (jet velocity 2.5 to 3.9m/s) were followed for 48+/-19 months. Haemodynamic progress...
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| Veröffentlicht in: | European heart journal 2004-02, Vol.25 (3), p.199-205 |
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| creator | ROSENHEK, Raphael KLAAR, Ursula SCHEMPER, Michael SCHOLTEN, Christine HEGER, Maria GABRIEL, Harald BINDER, Thomas MAURER, Gerald BAUMGARTNER, Helmut |
| description | To define the natural history and predictors of outcome in mild and moderate aortic stenosis (AS).
One hundred and seventy-six consecutive asymptomatic patients (73 women, age 58+/-19 years) with mild to moderate AS (jet velocity 2.5 to 3.9m/s) were followed for 48+/-19 months. Haemodynamic progression and clinical outcome was analysed. Event-free survival with end-points defined as death (n=34) or aortic valve surgery (n=33), was 95+/-2%, 75+/-3% and 60+/-5% at 1, 3 and 5 years, respectively. Both, cardiac and non-cardiac mortality were significantly increased, resulting in a 1.8 times higher mortality than expected (P |
| doi_str_mv | 10.1016/j.ehj.2003.12.002 |
| format | Article |
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One hundred and seventy-six consecutive asymptomatic patients (73 women, age 58+/-19 years) with mild to moderate AS (jet velocity 2.5 to 3.9m/s) were followed for 48+/-19 months. Haemodynamic progression and clinical outcome was analysed. Event-free survival with end-points defined as death (n=34) or aortic valve surgery (n=33), was 95+/-2%, 75+/-3% and 60+/-5% at 1, 3 and 5 years, respectively. Both, cardiac and non-cardiac mortality were significantly increased, resulting in a 1.8 times higher mortality than expected (P<0.005). By multivariate analysis, moderate to severe aortic valve calcification, coronary artery disease (CAD) and peak jet velocity were independent predictors of outcome. Event-free survival for patients with moderate or severe valve calcification was 92+/-4%, 61+/-7% and 42+/-7% at 1, 3 and 5 years versus 100%, 90+/-4% and 82+/-5% for patients with no or mild calcification. Patients with calcified aortic valves, CAD or with an event had a significantly faster haemodynamic progression. Of 129 patients with a follow-up echocardiographic exam, 59 (46%) developed severe stenosis during follow-up.
Outcome of mild and moderate AS is worse than commonly assumed. Rapid progression and excess mortality have to be considered. Significant valve calcification, CAD and rapid progression of aortic jet velocity indicate poor outcome. Patients with these characteristics may require closer follow-up than generally assumed.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1016/j.ehj.2003.12.002</identifier><identifier>PMID: 14972419</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Aged ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - etiology ; Aortic Valve Stenosis - mortality ; Biological and medical sciences ; Blood Flow Velocity - physiology ; Calcinosis - diagnostic imaging ; Calcinosis - etiology ; Calcinosis - mortality ; Cardiology. Vascular system ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - etiology ; Coronary Artery Disease - mortality ; Death, Sudden, Cardiac - etiology ; Disease-Free Survival ; Echocardiography ; Echocardiography, Doppler ; Endocardial and cardiac valvular diseases ; Epidemiologic Methods ; Female ; Heart ; Humans ; Male ; Medical sciences ; Multivariate Analysis ; Prognosis</subject><ispartof>European heart journal, 2004-02, Vol.25 (3), p.199-205</ispartof><rights>2004 INIST-CNRS</rights><rights>Copyright Oxford Publishing Limited(England) Feb 2004</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-597696f1b3c1657c46c4b1cc89a8646e023be38f81f231807c3d73e255a756a53</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15480846$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14972419$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ROSENHEK, Raphael</creatorcontrib><creatorcontrib>KLAAR, Ursula</creatorcontrib><creatorcontrib>SCHEMPER, Michael</creatorcontrib><creatorcontrib>SCHOLTEN, Christine</creatorcontrib><creatorcontrib>HEGER, Maria</creatorcontrib><creatorcontrib>GABRIEL, Harald</creatorcontrib><creatorcontrib>BINDER, Thomas</creatorcontrib><creatorcontrib>MAURER, Gerald</creatorcontrib><creatorcontrib>BAUMGARTNER, Helmut</creatorcontrib><title>Mild and moderate aortic stenosis: Natural history and risk stratification by echocardiography</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>To define the natural history and predictors of outcome in mild and moderate aortic stenosis (AS).
One hundred and seventy-six consecutive asymptomatic patients (73 women, age 58+/-19 years) with mild to moderate AS (jet velocity 2.5 to 3.9m/s) were followed for 48+/-19 months. Haemodynamic progression and clinical outcome was analysed. Event-free survival with end-points defined as death (n=34) or aortic valve surgery (n=33), was 95+/-2%, 75+/-3% and 60+/-5% at 1, 3 and 5 years, respectively. Both, cardiac and non-cardiac mortality were significantly increased, resulting in a 1.8 times higher mortality than expected (P<0.005). By multivariate analysis, moderate to severe aortic valve calcification, coronary artery disease (CAD) and peak jet velocity were independent predictors of outcome. Event-free survival for patients with moderate or severe valve calcification was 92+/-4%, 61+/-7% and 42+/-7% at 1, 3 and 5 years versus 100%, 90+/-4% and 82+/-5% for patients with no or mild calcification. Patients with calcified aortic valves, CAD or with an event had a significantly faster haemodynamic progression. Of 129 patients with a follow-up echocardiographic exam, 59 (46%) developed severe stenosis during follow-up.
Outcome of mild and moderate AS is worse than commonly assumed. Rapid progression and excess mortality have to be considered. Significant valve calcification, CAD and rapid progression of aortic jet velocity indicate poor outcome. Patients with these characteristics may require closer follow-up than generally assumed.</description><subject>Aged</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - etiology</subject><subject>Aortic Valve Stenosis - mortality</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity - physiology</subject><subject>Calcinosis - diagnostic imaging</subject><subject>Calcinosis - etiology</subject><subject>Calcinosis - mortality</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - etiology</subject><subject>Coronary Artery Disease - mortality</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Disease-Free Survival</subject><subject>Echocardiography</subject><subject>Echocardiography, Doppler</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Epidemiologic Methods</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Multivariate Analysis</subject><subject>Prognosis</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkMtKxDAUhoMoOl4ewI0UQXetOUmTpu5k8AZeNgquDGmaOqmdZkzaRd_e6AwIbs6Bw_f_HD6EjgFngIFftJlZtBnBmGZAMozJFpoBIyQtec620QxDyVLOxdse2g-hxRgLDnwX7UFeFiSHcobeH21XJ6qvk6WrjVeDSZTzg9VJGEzvgg2XyZMaRq-6ZGHD4Pz0S3sbPiMSA7axOk7XJ9WUGL1wWvnaug-vVovpEO00qgvmaLMP0OvN9cv8Ln14vr2fXz2kOud0SFlZ8JI3UFENnBXxqPMKtBalEjznBhNaGSoaAQ2hIHChaV1QQxhTBeOK0QN0vu5defc1mjDIpQ3adJ3qjRuDFBgKyiiO4Ok_sHWj7-NvkgBj0RDkEYI1pL0LwZtGrrxdKj9JwPLHvGxlNC9_zEsgMpqPmZNN8VgtTf2X2KiOwNkGUEGrrvGq1zb8cSwXWEQb34CbjE4</recordid><startdate>20040201</startdate><enddate>20040201</enddate><creator>ROSENHEK, Raphael</creator><creator>KLAAR, Ursula</creator><creator>SCHEMPER, Michael</creator><creator>SCHOLTEN, Christine</creator><creator>HEGER, Maria</creator><creator>GABRIEL, Harald</creator><creator>BINDER, Thomas</creator><creator>MAURER, Gerald</creator><creator>BAUMGARTNER, Helmut</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20040201</creationdate><title>Mild and moderate aortic stenosis: Natural history and risk stratification by echocardiography</title><author>ROSENHEK, Raphael ; KLAAR, Ursula ; SCHEMPER, Michael ; SCHOLTEN, Christine ; HEGER, Maria ; GABRIEL, Harald ; BINDER, Thomas ; MAURER, Gerald ; BAUMGARTNER, Helmut</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-597696f1b3c1657c46c4b1cc89a8646e023be38f81f231807c3d73e255a756a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - etiology</topic><topic>Aortic Valve Stenosis - mortality</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity - physiology</topic><topic>Calcinosis - diagnostic imaging</topic><topic>Calcinosis - etiology</topic><topic>Calcinosis - mortality</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - etiology</topic><topic>Coronary Artery Disease - mortality</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Disease-Free Survival</topic><topic>Echocardiography</topic><topic>Echocardiography, Doppler</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Epidemiologic Methods</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Multivariate Analysis</topic><topic>Prognosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ROSENHEK, Raphael</creatorcontrib><creatorcontrib>KLAAR, Ursula</creatorcontrib><creatorcontrib>SCHEMPER, Michael</creatorcontrib><creatorcontrib>SCHOLTEN, Christine</creatorcontrib><creatorcontrib>HEGER, Maria</creatorcontrib><creatorcontrib>GABRIEL, Harald</creatorcontrib><creatorcontrib>BINDER, Thomas</creatorcontrib><creatorcontrib>MAURER, Gerald</creatorcontrib><creatorcontrib>BAUMGARTNER, Helmut</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ROSENHEK, Raphael</au><au>KLAAR, Ursula</au><au>SCHEMPER, Michael</au><au>SCHOLTEN, Christine</au><au>HEGER, Maria</au><au>GABRIEL, Harald</au><au>BINDER, Thomas</au><au>MAURER, Gerald</au><au>BAUMGARTNER, Helmut</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mild and moderate aortic stenosis: Natural history and risk stratification by echocardiography</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>2004-02-01</date><risdate>2004</risdate><volume>25</volume><issue>3</issue><spage>199</spage><epage>205</epage><pages>199-205</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>To define the natural history and predictors of outcome in mild and moderate aortic stenosis (AS).
One hundred and seventy-six consecutive asymptomatic patients (73 women, age 58+/-19 years) with mild to moderate AS (jet velocity 2.5 to 3.9m/s) were followed for 48+/-19 months. Haemodynamic progression and clinical outcome was analysed. Event-free survival with end-points defined as death (n=34) or aortic valve surgery (n=33), was 95+/-2%, 75+/-3% and 60+/-5% at 1, 3 and 5 years, respectively. Both, cardiac and non-cardiac mortality were significantly increased, resulting in a 1.8 times higher mortality than expected (P<0.005). By multivariate analysis, moderate to severe aortic valve calcification, coronary artery disease (CAD) and peak jet velocity were independent predictors of outcome. Event-free survival for patients with moderate or severe valve calcification was 92+/-4%, 61+/-7% and 42+/-7% at 1, 3 and 5 years versus 100%, 90+/-4% and 82+/-5% for patients with no or mild calcification. Patients with calcified aortic valves, CAD or with an event had a significantly faster haemodynamic progression. Of 129 patients with a follow-up echocardiographic exam, 59 (46%) developed severe stenosis during follow-up.
Outcome of mild and moderate AS is worse than commonly assumed. Rapid progression and excess mortality have to be considered. Significant valve calcification, CAD and rapid progression of aortic jet velocity indicate poor outcome. Patients with these characteristics may require closer follow-up than generally assumed.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>14972419</pmid><doi>10.1016/j.ehj.2003.12.002</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0195-668X 1522-9645 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - etiology Aortic Valve Stenosis - mortality Biological and medical sciences Blood Flow Velocity - physiology Calcinosis - diagnostic imaging Calcinosis - etiology Calcinosis - mortality Cardiology. Vascular system Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - etiology Coronary Artery Disease - mortality Death, Sudden, Cardiac - etiology Disease-Free Survival Echocardiography Echocardiography, Doppler Endocardial and cardiac valvular diseases Epidemiologic Methods Female Heart Humans Male Medical sciences Multivariate Analysis Prognosis |
| title | Mild and moderate aortic stenosis: Natural history and risk stratification by echocardiography |
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