What is the prognosis of severe aortic stenosis (AS)?

Updated: May 07, 2019
  • Author: Xiushui (Mike) Ren, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

In general, the presence of low-gradient "severe stenosis" (defined as aortic valve area < 1.0 cm2 and mean gradient 40 mmHg), representing up to 40% of all patients with aortic stenosis, is considered to be associated with a poor prognosis. [13] However, the prospective Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study found that such patients have an outcome similar to that of patients with moderate stenosis. [14]  A more recent study found that symptomatic paradoxical low-gradient severe aortic stenosis is associated with a poorer prognosis even after adjustment for flow status and aortic stenosis severity. [15] Moreover, the investigators indicated there may be a possible link to heart failure with preserved ejection fraction in some symptomatic patients. [15]

Epicardial adipose tissue (EAT) volume appears to be associated with adverse outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). A retrospective study of 503 such patients found EAT volume was independently associated with all-cause 1-, 2-, and 3-year mortality and the early safety endpoint at 30 days. [16]


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