Frey, Norbert ORCID: 0000-0001-7611-378X, Steeds, Richard Paul, Rudolph, Tanja K., Thambyrajah, Jeetendra, Serra, Antonio, Schulz, Eberhard, Maly, Jiri, Aiello, Marco, Lloyd, Guy, Santo Bortone, Alessandro, Hauptmann, Karl Eugen, Clerici, Alberto, Delle Karth, Georg, Rieber, Johannes, Indorfi, Ciro, Mancone, Massimo, Belle, Loic, Lauten, Alexander, Arnold, Martin, Bouma, Berto J., Lutz, Matthias, Pohlmann, Christiane, Kurucova, Jana, Thoenes, Martin, Bramlage, Peter and Messika-Zeitoun, David (2019). Symptoms, disease severity and treatment of adults with a new diagnosis of severe aortic stenosis. Heart, 105 (22). S. 1709 - 1717. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-201X

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Abstract

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 cm(2), indexed AVA <0.6 cm(2)/m(2), maximum jet-velocity (V-max) >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 cm(2), V(max)4.3 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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Frey, NorbertUNSPECIFIEDorcid.org/0000-0001-7611-378XUNSPECIFIED
Steeds, Richard PaulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rudolph, Tanja K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thambyrajah, JeetendraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Serra, AntonioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schulz, EberhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maly, JiriUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aiello, MarcoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lloyd, GuyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Santo Bortone, AlessandroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hauptmann, Karl EugenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Clerici, AlbertoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Delle Karth, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rieber, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Indorfi, CiroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mancone, MassimoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Belle, LoicUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lauten, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arnold, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bouma, Berto J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lutz, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pohlmann, ChristianeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kurucova, JanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thoenes, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bramlage, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Messika-Zeitoun, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-129093
DOI: 10.1136/heartjnl-2019-314940
Journal or Publication Title: Heart
Volume: 105
Number: 22
Page Range: S. 1709 - 1717
Date: 2019
Publisher: BMJ PUBLISHING GROUP
Place of Publication: LONDON
ISSN: 1468-201X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
VALVULAR HEART-DISEASE; VALVE-REPLACEMENT; IMPLANTATION; GUIDELINES; MANAGEMENTMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/12909

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