Materiały źródłowe

• #1 Aortic stenosis: An update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2999052/

  Aortic stenosis (AS) is the most common valvular heart disease in the world. It is a disease of the elderly and as our population is getting older in both the developed and the developing world, there has been an increase in the prevalence of AS. It is impacting the mortality and morbidity of our elderly population. It is also causing a huge burden on the healthcare system. […] The prevalence of AS increases from 2% in adults over 65 years to 4% in adults over 85 years of age. AS is a progressive condition and after the onset of heart failure, survival is 2 years without valve replacement. 50% of patients with AS presenting with angina, syncope or heart failure survive for 5, 3 or 2 years respectively without aortic valve replacement (AVR). As life spans increase, the burden of senile AS on the health care system is expected to increase. Close monitoring and use of AVR when the disease becomes significant remains the standard of care. AS is the most common reason for AVR in the developed world.

• #2 Aortic valve stenosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/aortic-valve-stenosis?lang=us

  Aortic stenosis is the most common valvulopathy, present in up to one-quarter of all patients with chronic valvular heart disease 1,2. The condition has a male predilection in a 4:1 ratio 1, and the incidence of degenerative aortic valve disease, the most common etiology of aortic stenosis, is increasing 1,2. […] The decision to treat aortic stenosis is based on the severity 1,2. Management involves a combination of lifestyle and pharmacotherapy measures (a similar armamentarium to that used in heart failure), balloon valvuloplasty, and aortic valve replacement 1,2.

• #3

  https://link.springer.com/article/10.1007/s11936-023-01020-4

  This review aims to update healthcare providers on contemporary diagnostic and treatment information pertaining to aortic stenosis. […] The prevalence of aortic stenosis continues to increase, and so does the burden of treatable disease. This has important implications for healthcare systems and the economy. […] The global prevalence of AS continues to steadily increase. […] The age-standardized prevalence of calcific aortic valve disease was 116.3 cases per 100,000 people in 2019, more than doubling since 1990. […] AS is particularly prevalent in high-income countries, partly driven by its strong correlation with age; pooled meta-data suggest contemporary prevalence exceeds 10% in the population aged over 75 years. […] This creates significant challenges for healthcare infrastructure and resource allocation, given the growing treatable burden of disease.

• #4 Aortic Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557628/

  Aortic stenosis is a common valvular disorder, especially in the elderly population, causing left ventricular outflow obstruction. […] The prevalence of calcific aortic sclerosis is about 1% to 2% in patients aged 65 or less and 29% in patients aged 65 or more. About 2 to 9% of patients aged greater than 75 have severe aortic stenosis. […] The causes of aortic stenosis vary geographically as calcific stenosis is more common in North America and Europe, while rheumatic valve disease is more common in developing countries. The number is expected to increase twofold or threefold in the coming decades with the aging of the population.

• #5 Aortic stenosis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Aortic_stenosis_epidemiology_and_demographics

  Aortic stenosis is a major health problem that primarily affects the elderly. The majority of cases of aortic stenosis is due to calcific degeneration. Aortic stenosis tends to affect approximately 1% of patients over the age of 65, 2% of patients over the age of 75, and 4% of patients over the age 85. […] The prevalence of aortic stenosis is approximately 3% in adults over 75 years. […] According to the Cardiovascular Health Study, the prevalence of aortic stenosis among patients more than 65 years of age is approximately 2% in the United States. […] The prevalence of aortic stenosis increases with age. […] Approximately 1% of patients over the age of 65, 2% of patients over the age of 75, and 4% of patients over the age of 85 have aortic stenosis. […] Calcific degenerative aortic stenosis is more common in males. […] In North America and Europe, a linear relationship exists between the increase in the incidence of aortic stenosis and the increase in aging population.

• #6 Epidemiology of aortic valve stenosis (AS) and of aortic valve incompetence (AI): is the prevalence of AS/AI similar in different parts of the world?

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/epidemiology-of-aortic-valve-stenosis-as-and-of-aortic-valve-incompetence-ai

  There are large differences in the epidemiology of aortic valve disease between high-income and low-income countries. […] The prevalence of severe aortic stenosis in those aged 75 years is 3.4% in Europe and the USA. […] Aortic stenosis is the second most common valvular lesion in the United States. It is present in about 5% of the population at age 65 with increasing prevalence with advancing age. […] A meta-analysis of predominantly older studies conducted in Europe, the USA and Taiwan found a population prevalence of AS of 12.4%, and a prevalence of 3.4% of severe AS in those aged 75 years and older. […] Projections in high-income countries uniformly predict an increase in the burden of disease. […] The high prevalence of risk factors for CAVD such as hypertension and increasing life expectancy, mean that there is likely to be a substantial future burden of CAVD in low-income countries. […] Epidemiologic studies have established equal rates of AS among men and women; however, important sex differences exist.

• #7 Aortic stenosis: Update in monitoring and management

  https://www1.racgp.org.au/ajgp/2024/july/aortic-stenosis

  Aortic stenosis (AS) remains one of the most commonly encountered valvular pathologies. […] The Australian prevalence of severe AS is estimated at 1.5% of the population aged 55 years and 3.5% in those aged 75 years, with a yearly incidence of 1.8 per 1000 people. […] Early detection and management are crucial for optimal patient outcomes in severe AS because untreated AS is associated with a two-year mortality rate of 30-50%. […] In the majority of cases, it is recommended that asymptomatic patients with severe AS undergo watchful waiting with repeat echocardiogram every 6-12 months. […] Aortic valve replacement is the only treatment that improves mortality in patients with symptomatic severe AS. […] For patients with symptomatic severe high-gradient AS, aortic valve replacement improves survival, symptoms and left ventricular systolic function.

• #8 The evolving epidemiology of valvular aortic stenosis. The Tromsø Study | Heart

  https://heart.bmj.com/content/99/6/396

  Objective To assess prevalence, incidence, prognosis and progression of degenerative valvular aortic stenosis (AS). […] Prevalence studies have been conducted previously, and several authors have investigated the prognosis and progression of clinical AS, but to our knowledge there are no population-based incidence studies or progression studies available. […] The results of the prevalence calculations both for the surveys and after inclusion of hospital data are displayed in table 2. At all three time points we consistently found an increase in prevalence with age, weighted mean values in the combined survey T4/5/6 and hospital data being 0.2% (95% CI 0% to 0.4%) in the 50-59 year cohort, 1.3% (95% CI 0.9% to 1.7%) in the 60-69 year cohort, 3.9% (95% CI 3.2% to 4.6%) in the 70-79 year cohort and 9.8% (95% CI 7.8% to 11.8%) in the 80-89 year cohort. Thus, the prevalence increases exponentially with age.

• #9 Aortic stenosis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Aortic_stenosis_epidemiology_and_demographics

  Aortic stenosis is a major health problem that primarily affects the elderly. The majority of cases of aortic stenosis is due to calcific degeneration. Aortic stenosis tends to affect approximately 1% of patients over the age of 65, 2% of patients over the age of 75, and 4% of patients over the age 85. […] The prevalence of aortic stenosis is approximately 3% in adults over 75 years. […] According to the Cardiovascular Health Study, the prevalence of aortic stenosis among patients more than 65 years of age is approximately 2% in the United States. […] The prevalence of aortic stenosis increases with age. […] Approximately 1% of patients over the age of 65, 2% of patients over the age of 75, and 4% of patients over the age of 85 have aortic stenosis. […] Calcific degenerative aortic stenosis is more common in males. […] In North America and Europe, a linear relationship exists between the increase in the incidence of aortic stenosis and the increase in aging population.

• #10 Epidemiology of aortic valve stenosis (AS) and of aortic valve incompetence (AI): is the prevalence of AS/AI similar in different parts of the world?

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/epidemiology-of-aortic-valve-stenosis-as-and-of-aortic-valve-incompetence-ai

  There are large differences in the epidemiology of aortic valve disease between high-income and low-income countries. […] The prevalence of severe aortic stenosis in those aged 75 years is 3.4% in Europe and the USA. […] Aortic stenosis is the second most common valvular lesion in the United States. It is present in about 5% of the population at age 65 with increasing prevalence with advancing age. […] A meta-analysis of predominantly older studies conducted in Europe, the USA and Taiwan found a population prevalence of AS of 12.4%, and a prevalence of 3.4% of severe AS in those aged 75 years and older. […] Projections in high-income countries uniformly predict an increase in the burden of disease. […] The high prevalence of risk factors for CAVD such as hypertension and increasing life expectancy, mean that there is likely to be a substantial future burden of CAVD in low-income countries. […] Epidemiologic studies have established equal rates of AS among men and women; however, important sex differences exist.

• #11 Aortic stenosis: Update in monitoring and management

  https://www1.racgp.org.au/ajgp/2024/july/aortic-stenosis

  Aortic stenosis (AS) remains one of the most commonly encountered valvular pathologies. […] The Australian prevalence of severe AS is estimated at 1.5% of the population aged 55 years and 3.5% in those aged 75 years, with a yearly incidence of 1.8 per 1000 people. […] Early detection and management are crucial for optimal patient outcomes in severe AS because untreated AS is associated with a two-year mortality rate of 30-50%. […] In the majority of cases, it is recommended that asymptomatic patients with severe AS undergo watchful waiting with repeat echocardiogram every 6-12 months. […] Aortic valve replacement is the only treatment that improves mortality in patients with symptomatic severe AS. […] For patients with symptomatic severe high-gradient AS, aortic valve replacement improves survival, symptoms and left ventricular systolic function.

• #12 Aortic Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557628/

  Aortic stenosis is a common valvular disorder, especially in the elderly population, causing left ventricular outflow obstruction. […] The prevalence of calcific aortic sclerosis is about 1% to 2% in patients aged 65 or less and 29% in patients aged 65 or more. About 2 to 9% of patients aged greater than 75 have severe aortic stenosis. […] The causes of aortic stenosis vary geographically as calcific stenosis is more common in North America and Europe, while rheumatic valve disease is more common in developing countries. The number is expected to increase twofold or threefold in the coming decades with the aging of the population.

• #13 The Global Burden of Valvular Heart Disease: From Clinical Epidemiology to Management

  https://www.mdpi.com/2077-0383/12/6/2178

  According to the Euro Heart Survey on Valvular Disease, AS is the most common VHD in developed countries, and its etiology is degenerative-calcific in most patients (81.9%), rheumatic in 11.2%, congenital in 5.6%, and post-endocarditis in the remaining 1.3%. […] The prevalence of aortic sclerosis in individuals over 75 is about 40%, and, as the degenerative process is very slow, only 2% progress every year to hemodynamically significant AS. […] Osnabrugge et al. have shown that the prevalence of all types of AS in the elderly is 12.4% and the prevalence of severe stenosis is 3.4%. […] Despite atherosclerotic disease and AS sharing hypercholesterolemia and hypertension as risk factors, diabetes seems to predispose to the development of AS and to faster its progression, especially from mild to severe stenosis, but the data supporting this hypothesis are still inconsistent.

• #14 The Global Burden of Valvular Heart Disease: From Clinical Epidemiology to Management

  https://www.mdpi.com/2077-0383/12/6/2178

  According to the Euro Heart Survey on Valvular Disease, AS is the most common VHD in developed countries, and its etiology is degenerative-calcific in most patients (81.9%), rheumatic in 11.2%, congenital in 5.6%, and post-endocarditis in the remaining 1.3%. […] The prevalence of aortic sclerosis in individuals over 75 is about 40%, and, as the degenerative process is very slow, only 2% progress every year to hemodynamically significant AS. […] Osnabrugge et al. have shown that the prevalence of all types of AS in the elderly is 12.4% and the prevalence of severe stenosis is 3.4%. […] Despite atherosclerotic disease and AS sharing hypercholesterolemia and hypertension as risk factors, diabetes seems to predispose to the development of AS and to faster its progression, especially from mild to severe stenosis, but the data supporting this hypothesis are still inconsistent.

• #15 Epidemiology and cardiovascular risk factors of aortic stenosis | Cardiovascular Ultrasound | Full Text

  https://cardiovascularultrasound.biomedcentral.com/articles/10.1186/1476-7120-4-27

  The abnormalities of aortic valve morphology and function represent the most common cardiac-valve lesion particularly in elderly. […] The aortic valve stenosis is present in 29% of general population over 65 years of age; an increased prevalence of both sclerosis and stenosis with aging (48% and 4% in those over 85 years) is observed. […] In the Euro Heart Survey on Valvular Heart Disease, aortic valve stenosis was the most common valve abnormality (33,9% and 46,6% in the overall group and surgical subgroup, respectively). […] The etiology of aortic stenosis was degenerative-calcific in the majority of patients (81,9%), while it was rheumatic in 11.2%, congenital in 5.6% and post-endocarditis in the remaining 1,3%. […] Aortic valve calcification is frequent in end-stage renal failure and dialysis subjects; among 155 hemodialysis patients referred to our echo laboratory in the last 12 months, some degree of aortic valve sclerosis was found in 66,5%, aortic valve stenosis in 17,5% and only 16% of subjects had a normal aortic valve.

• #16 Epidemiology of aortic valve stenosis (AS) and of aortic valve incompetence (AI): is the prevalence of AS/AI similar in different parts of the world?

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/epidemiology-of-aortic-valve-stenosis-as-and-of-aortic-valve-incompetence-ai

  There are large differences in the epidemiology of aortic valve disease between high-income and low-income countries. […] The prevalence of severe aortic stenosis in those aged 75 years is 3.4% in Europe and the USA. […] Aortic stenosis is the second most common valvular lesion in the United States. It is present in about 5% of the population at age 65 with increasing prevalence with advancing age. […] A meta-analysis of predominantly older studies conducted in Europe, the USA and Taiwan found a population prevalence of AS of 12.4%, and a prevalence of 3.4% of severe AS in those aged 75 years and older. […] Projections in high-income countries uniformly predict an increase in the burden of disease. […] The high prevalence of risk factors for CAVD such as hypertension and increasing life expectancy, mean that there is likely to be a substantial future burden of CAVD in low-income countries. […] Epidemiologic studies have established equal rates of AS among men and women; however, important sex differences exist.

• #17 Aortic valve stenosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/aortic-valve-stenosis?lang=us

  Aortic stenosis is the most common valvulopathy, present in up to one-quarter of all patients with chronic valvular heart disease 1,2. The condition has a male predilection in a 4:1 ratio 1, and the incidence of degenerative aortic valve disease, the most common etiology of aortic stenosis, is increasing 1,2. […] The decision to treat aortic stenosis is based on the severity 1,2. Management involves a combination of lifestyle and pharmacotherapy measures (a similar armamentarium to that used in heart failure), balloon valvuloplasty, and aortic valve replacement 1,2.

• #18 Pediatric Valvar Aortic Stenosis: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/894095-overview

  Aortic valve stenosis accounts for 3%-5% of all congenital heart defects. […] Authorities estimate a bicuspid aortic valve is present in as many as 1% of the general population, although accurate figures regarding prevalence of this abnormality are difficult to obtain, because many cases remain undetected and these valves function well for many decades. […] Some studies have documented a higher prevalence of aortic valve stenosis in white children than in black and Hispanic children. […] There is a strong male sex predilection in aortic valve stenosis: the male-to-female ratio is 4:1.

• #19 Sex-related disparities in aortic stenosis from disease awareness to treatment: a state-of-the-art review – Appleby – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/90835/html

  Several studies have shown that AS in women is often diagnosed late in their disease trajectory with a more significant risk profile, such as advanced age, more symptomatic burden, frailty, renal insufficiency, and a higher rate of symptomatic heart failure. […] One of the potential reasons for this delayed diagnosis is the lack of awareness about the disease. […] According to data gathered from the United States administrative claim databases, women with AS received fewer referrals for specialist care and underwent fewer diagnostic tests compared to male patients. […] Similar lower referral rates to SAVR in women were reported by Bienjonetti et al. and other studies. […] Although TAVR is as common in women as men, they experience longer workup and procedural waiting, leading to higher 30-day mortality and HF hospitalization compared to men.

• #20 Sex-related disparities in aortic stenosis from disease awareness to treatment: a state-of-the-art review – Appleby – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/90835/html

  Several studies have shown that AS in women is often diagnosed late in their disease trajectory with a more significant risk profile, such as advanced age, more symptomatic burden, frailty, renal insufficiency, and a higher rate of symptomatic heart failure. […] One of the potential reasons for this delayed diagnosis is the lack of awareness about the disease. […] According to data gathered from the United States administrative claim databases, women with AS received fewer referrals for specialist care and underwent fewer diagnostic tests compared to male patients. […] Similar lower referral rates to SAVR in women were reported by Bienjonetti et al. and other studies. […] Although TAVR is as common in women as men, they experience longer workup and procedural waiting, leading to higher 30-day mortality and HF hospitalization compared to men.

• #21 Epidemiology of aortic valve stenosis (AS) and of aortic valve incompetence (AI): is the prevalence of AS/AI similar in different parts of the world?

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/epidemiology-of-aortic-valve-stenosis-as-and-of-aortic-valve-incompetence-ai

  There are large differences in the epidemiology of aortic valve disease between high-income and low-income countries. […] The prevalence of severe aortic stenosis in those aged 75 years is 3.4% in Europe and the USA. […] Aortic stenosis is the second most common valvular lesion in the United States. It is present in about 5% of the population at age 65 with increasing prevalence with advancing age. […] A meta-analysis of predominantly older studies conducted in Europe, the USA and Taiwan found a population prevalence of AS of 12.4%, and a prevalence of 3.4% of severe AS in those aged 75 years and older. […] Projections in high-income countries uniformly predict an increase in the burden of disease. […] The high prevalence of risk factors for CAVD such as hypertension and increasing life expectancy, mean that there is likely to be a substantial future burden of CAVD in low-income countries. […] Epidemiologic studies have established equal rates of AS among men and women; however, important sex differences exist.

• #22 Epidemiology of aortic valve stenosis (AS) and of aortic valve incompetence (AI): is the prevalence of AS/AI similar in different parts of the world?

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/epidemiology-of-aortic-valve-stenosis-as-and-of-aortic-valve-incompetence-ai

  There are large differences in the epidemiology of aortic valve disease between high-income and low-income countries. […] The prevalence of severe aortic stenosis in those aged 75 years is 3.4% in Europe and the USA. […] Aortic stenosis is the second most common valvular lesion in the United States. It is present in about 5% of the population at age 65 with increasing prevalence with advancing age. […] A meta-analysis of predominantly older studies conducted in Europe, the USA and Taiwan found a population prevalence of AS of 12.4%, and a prevalence of 3.4% of severe AS in those aged 75 years and older. […] Projections in high-income countries uniformly predict an increase in the burden of disease. […] The high prevalence of risk factors for CAVD such as hypertension and increasing life expectancy, mean that there is likely to be a substantial future burden of CAVD in low-income countries. […] Epidemiologic studies have established equal rates of AS among men and women; however, important sex differences exist.

• #23

  https://link.springer.com/article/10.1007/s11936-023-01020-4

  This review aims to update healthcare providers on contemporary diagnostic and treatment information pertaining to aortic stenosis. […] The prevalence of aortic stenosis continues to increase, and so does the burden of treatable disease. This has important implications for healthcare systems and the economy. […] The global prevalence of AS continues to steadily increase. […] The age-standardized prevalence of calcific aortic valve disease was 116.3 cases per 100,000 people in 2019, more than doubling since 1990. […] AS is particularly prevalent in high-income countries, partly driven by its strong correlation with age; pooled meta-data suggest contemporary prevalence exceeds 10% in the population aged over 75 years. […] This creates significant challenges for healthcare infrastructure and resource allocation, given the growing treatable burden of disease.

• #24 Aortic Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557628/

  Aortic stenosis is a common valvular disorder, especially in the elderly population, causing left ventricular outflow obstruction. […] The prevalence of calcific aortic sclerosis is about 1% to 2% in patients aged 65 or less and 29% in patients aged 65 or more. About 2 to 9% of patients aged greater than 75 have severe aortic stenosis. […] The causes of aortic stenosis vary geographically as calcific stenosis is more common in North America and Europe, while rheumatic valve disease is more common in developing countries. The number is expected to increase twofold or threefold in the coming decades with the aging of the population.

• #25 Epidemiology and cardiovascular risk factors of aortic stenosis | Cardiovascular Ultrasound | Full Text

  https://cardiovascularultrasound.biomedcentral.com/articles/10.1186/1476-7120-4-27

  The abnormalities of aortic valve morphology and function represent the most common cardiac-valve lesion particularly in elderly. […] The aortic valve stenosis is present in 29% of general population over 65 years of age; an increased prevalence of both sclerosis and stenosis with aging (48% and 4% in those over 85 years) is observed. […] In the Euro Heart Survey on Valvular Heart Disease, aortic valve stenosis was the most common valve abnormality (33,9% and 46,6% in the overall group and surgical subgroup, respectively). […] The etiology of aortic stenosis was degenerative-calcific in the majority of patients (81,9%), while it was rheumatic in 11.2%, congenital in 5.6% and post-endocarditis in the remaining 1,3%. […] Aortic valve calcification is frequent in end-stage renal failure and dialysis subjects; among 155 hemodialysis patients referred to our echo laboratory in the last 12 months, some degree of aortic valve sclerosis was found in 66,5%, aortic valve stenosis in 17,5% and only 16% of subjects had a normal aortic valve.

• #26 Epidemiology and cardiovascular risk factors of aortic stenosis | Cardiovascular Ultrasound | Full Text

  https://cardiovascularultrasound.biomedcentral.com/articles/10.1186/1476-7120-4-27

  The abnormalities of aortic valve morphology and function represent the most common cardiac-valve lesion particularly in elderly. […] The aortic valve stenosis is present in 29% of general population over 65 years of age; an increased prevalence of both sclerosis and stenosis with aging (48% and 4% in those over 85 years) is observed. […] In the Euro Heart Survey on Valvular Heart Disease, aortic valve stenosis was the most common valve abnormality (33,9% and 46,6% in the overall group and surgical subgroup, respectively). […] The etiology of aortic stenosis was degenerative-calcific in the majority of patients (81,9%), while it was rheumatic in 11.2%, congenital in 5.6% and post-endocarditis in the remaining 1,3%. […] Aortic valve calcification is frequent in end-stage renal failure and dialysis subjects; among 155 hemodialysis patients referred to our echo laboratory in the last 12 months, some degree of aortic valve sclerosis was found in 66,5%, aortic valve stenosis in 17,5% and only 16% of subjects had a normal aortic valve.

• #27 Risk factors for aortic stenosis

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/risk-factors-for-aortic-stenosis

  Although aortic valve stenosis (AVS) shares several risk factors with atherosclerosis, lipid-lowering therapy does not reduce AVS progression. Elevated lipoprotein(a), hypertension, chronic kidney disease, and diabetes all increase the risk of AVS. In addition, recent studies have emphasised increased body mass index (BMI) as a particularly strong AVS risk factor. Modifying risk factors for AVS may reduce morbidity and potentially avoid valve interventions with health economic benefits. […] The increased prevalence of non-rheumatic aortic valve disease parallels an increasingly ageing population. Degenerative AVS is the most common valvular heart disease and develops from fibrocalcific changes of the aortic valve cusps, resulting in reduced valve opening and eventually haemodynamic obstruction of the left ventricular outflow.

• #28 Risk factors for aortic stenosis

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/risk-factors-for-aortic-stenosis

  Assessing the association of traditional cardiovascular risk factors with incident aortic valve disease is therefore important in order to identify potential preventive strategies in valvular heart disease. Identifying key risk factors for AVS may, in addition, provide clues for risk stratification and future interventional trials to slow down AVS progression and to avoid, or at least postpone, aortic valve interventions. […] Hypertension is present in 21% of those with AVS, and 1.1% of hypertensive subjects have AVS. However, only a few longitudinal studies have evaluated the association of hypertension with incident AVS. A recent cohort study of 5.4 million subjects followed for a median of 9.2 years through UK electronic healthcare records showed that elevated systolic blood pressure increased the risk of both AVS and AR with approximately 40% for each incremental 20 mmHg.

• #29 Risk factors for aortic stenosis

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/risk-factors-for-aortic-stenosis

  A database study of serum creatinine measures from 1.1 million subjects revealed that decreased glomerular filtration rate (GFR) was associated with an increased risk of incident AVS. Compared with reference (GFR 90 ml/min/1.73 m2), even a slight decrease in kidney function (GFR 60-90) was associated with a 14% higher risk of developing AVS. This risk increased with decreasing kidney function reaching a 56% increased risk of incident AVS in subjects with a GFR 30. […] Type 2 diabetes mellitus (T2DM) was associated with an increased incident AVS in retrospective studies. Given the close connection between cardiometabolic risk factors, it is also important that obesity is taken into consideration as a possible confounder for the relationship between T2DM and AVS. […] There is an urgent need for prospectively evaluating the effects of risk modifications as well as treatments targeting the potential AVS risk factors. Examples of such therapeutic strategies could potentially include weight loss, Lp(a) lowering, smoking cessation, as well as antihypertensive and antidiabetic treatments. Deciphering the risk factors contributing to AVS incidence and progression will be key in designing preventive measures for slowing down AVS progression, and eventually preventing, or at least postponing, AVS interventions.

• #30 Establishing an aortic stenosis surveillance clinic – The British Journal of Cardiology

  https://bjcardio.co.uk/2010/11/establishing-an-aortic-stenosis-surveillance-clinic/

  The number of patients with aortic stenosis (AS) in the UK is increasing. […] Establishment of a national AS surveillance programme could result in a large number of patients (9,000) being discharged from formal doctor-led cardiology clinic review in the UK. This would improve quality and consistency of follow-up monitoring for the patient and free up capacity to see new patients. […] Aortic stenosis (AS) is the most common form of valvular heart disease. The incidence is increasing due to an ageing population. […] Within the UK, demand for specialist cardiology services continues to increase. […] An AS surveillance clinic can result in a modest reduction in patients attending the cardiology out-patient department. […] Widespread national implementation of such clinics should be considered.

• #31 Establishing an aortic stenosis surveillance clinic – The British Journal of Cardiology

  https://bjcardio.co.uk/2010/11/establishing-an-aortic-stenosis-surveillance-clinic/

  The number of patients with aortic stenosis (AS) in the UK is increasing. […] Establishment of a national AS surveillance programme could result in a large number of patients (9,000) being discharged from formal doctor-led cardiology clinic review in the UK. This would improve quality and consistency of follow-up monitoring for the patient and free up capacity to see new patients. […] Aortic stenosis (AS) is the most common form of valvular heart disease. The incidence is increasing due to an ageing population. […] Within the UK, demand for specialist cardiology services continues to increase. […] An AS surveillance clinic can result in a modest reduction in patients attending the cardiology out-patient department. […] Widespread national implementation of such clinics should be considered.

• #32 Moderate aortic stenosis: culprit or bystander? | Open Heart

  https://openheart.bmj.com/content/9/1/e001743

  Non-rheumatic aortic stenosis (AS) is among the most common valvular diseases in the developed world. Current guidelines support aortic valve replacement (AVR) for severe symptomatic AS, which carries high morbidity and mortality when left untreated. […] In contrast, moderate AS has historically been thought to be a benign diagnosis for which the potential benefits of AVR are outweighed by the procedural risks. However, emerging data demonstrating the substantial mortality risk in untreated moderate AS and substantial improvements in periprocedural and perioperative mortality with AVR have challenged the traditional risk/benefit paradigm. […] The prevalence of AS increases with age, with about 12.4% of adults over age 75 with mild, moderate or severe AS. […] Current guidelines account for the crescendo progression pattern of AS by recommending more frequent surveillance echocardiograms when the disease progresses from mild to moderate (from every 3-5 years to every 1-2 years).

• #33 Aortic Stenosis | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/aortic-stenosis

  The aorta is the main artery that carries oxygen-rich blood from the heart to the rest of your body. When the valve between your heart and aorta becomes narrowed, you have a condition called aortic valve stenosis. […] Aortic stenosis is the most common form of valvular heart disease, occurring more often in men than women. For most people, the condition develops with age. More than 2.5 million people over the age of 75 in the United States have aortic stenosis. […] To monitor your condition, the American College of Cardiology and American Heart Association recommend having an echocardiogram every three to five years if you have mild aortic stenosis and every one to two years if you have moderate aortic stenosis.

• #34 Aortic Stenosis – Cardiovascular Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/cardiovascular-disorders/valvular-disorders/aortic-stenosis

  Aortic stenosis progresses faster as severity increases, but the wide variability in progression rates requires regular surveillance, particularly in sedentary older patients. […] Asymptomatic patients with severe AS and normal systolic function should be reevaluated every 6 months because 3 to 6% will develop symptoms of LVEF impairment every year. […] The risk of surgery outweighs the survival benefit in asymptomatic patients, but with the onset of symptoms the mean survival plummets to 2 to 3 years, and prompt valve replacement is indicated to relieve symptoms and improve survival. […] Risk of surgery increases for patients who require simultaneous CABG and for those with depressed systolic LV function. […] In patients with severe AS, about 50% of deaths occur suddenly, and these patients should be advised to limit physical exertion.

• #35 Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome | Scientific Reports

  https://www.nature.com/articles/s41598-022-25571-x

  In patients with bicuspid aortic valves, guidelines call for regular follow-up to monitor disease progression and guide intervention. […] Follow-up care for patients with bicuspid aortic valve was highly variable, and surveillance imaging was sparse despite guidelines. […] The risk of these pathologies has prompted guidelines for surveillance of patients with BAV in order to guide timely intervention. […] The 2018 American Association for Thoracic Surgery (AATS) guidelines for the management of BAV recommend serial evaluations of the aorta by transthoracic echocardiogram (TTE) with intervals tailored to the presence and severity of aortic dilation. […] Overall, all major cardiology and cardiac surgery societies recommend careful surveillance in BAV patients. […] Current guidelines suggest that the frequency and type of surveillance should be based on severity of aortic dilatation.

• #36 Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome | Scientific Reports

  https://www.nature.com/articles/s41598-022-25571-x

  In patients with bicuspid aortic valves, guidelines call for regular follow-up to monitor disease progression and guide intervention. […] Follow-up care for patients with bicuspid aortic valve was highly variable, and surveillance imaging was sparse despite guidelines. […] The risk of these pathologies has prompted guidelines for surveillance of patients with BAV in order to guide timely intervention. […] The 2018 American Association for Thoracic Surgery (AATS) guidelines for the management of BAV recommend serial evaluations of the aorta by transthoracic echocardiogram (TTE) with intervals tailored to the presence and severity of aortic dilation. […] Overall, all major cardiology and cardiac surgery societies recommend careful surveillance in BAV patients. […] Current guidelines suggest that the frequency and type of surveillance should be based on severity of aortic dilatation.

• #37 Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome | Scientific Reports

  https://www.nature.com/articles/s41598-022-25571-x

  This gap in quality of care attests to the importance of interdisciplinary communication between cardiology, radiology, and cardiac surgery. […] Overall, follow-up and use of surveillance imaging of the aorta or the aortic valve may be variable despite awareness of guideline recommendations. There is an urgent need for systematic surveillance and implementation of clinical follow-up mechanisms to monitor this patient population with increased risk of progressive valvulopathy and aortopathy.

• #38 Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome | Scientific Reports

  https://www.nature.com/articles/s41598-022-25571-x

  This gap in quality of care attests to the importance of interdisciplinary communication between cardiology, radiology, and cardiac surgery. […] Overall, follow-up and use of surveillance imaging of the aorta or the aortic valve may be variable despite awareness of guideline recommendations. There is an urgent need for systematic surveillance and implementation of clinical follow-up mechanisms to monitor this patient population with increased risk of progressive valvulopathy and aortopathy.

• #39 Rethinking the Management of Asymptomatic Severe Aortic Valve Stenosis: Embracing Early Intervention for Better Outcomes in: Texas Heart Institute Journal Volume 51: Issue 1 | Texas Heart Institute Journal

  https://doi.org/10.14503/THIJ-23-8295

  Symptomatic aortic stenosis (AS) is a class I indication for aortic valve replacement. Severe asymptomatic AS, however, has traditionally been managed conservatively using an expectant approach. […] Recent studies have raised concerns about this watchful waiting strategy because evidence suggests that it may lead to long-term morbidity and premature death, even after valve replacement. […] Asymptomatic severe AS is a common condition affecting older adults and carries a substantial risk of progression to severe disease over time. Current guidelines recommend a strategy of expectant management until symptoms or LV dysfunction develop, but recent evidence challenges this approach. […] The findings from recent trials, such as RECOVERY and AVATAR, have provided support for early surgical aortic valve replacement. Ongoing research on preemptive aortic valve replacement likely will expand treatment options and further endorse early intervention, transforming the care of patients with asymptomatic severe AS.

• #40 Evaluation of TAVR Compared to Surveillance for Patients With Asymptomatic Severe Aortic Stenosis – EARLY TAVR

  https://www.acc.org/latest-in-cardiology/clinical-trials/2024/10/24/14/42/early-tavr

  The EARLY TAVR trial showed that TAVR for stage C aortic stenosis was beneficial compared with clinical surveillance. […] The goal of the trial was to evaluate transcatheter aortic valve replacement (TAVR) compared with clinical surveillance among patients with asymptomatic severe aortic stenosis (stage C aortic stenosis). […] Among patients with asymptomatic severe aortic stenosis (stage C aortic stenosis), early TAVR was beneficial. Early TAVR compared with clinical surveillance resulted in a lower incidence of the composite outcome of death, stroke, or unplanned hospitalization for cardiovascular cause. This trial will be used to inform future guideline recommendations regarding the management of stage C aortic stenosis.

• #41 TCT

  https://www.healio.com/news/cardiology/20241028/early-tavr-bests-surveillance-in-patients-with-asymptomatic-severe-aortic-stenosis

  TAVR was superior to clinical surveillance in patients with asymptomatic severe aortic stenosis. […] Almost all patients in the clinical surveillance group eventually needed TAVR. […] Among patients with asymptomatic severe aortic stenosis, those who had transcatheter aortic valve replacement had better CV outcomes compared with those who had routine clinical surveillance, according to results of the EARLY TAVR trial. […] In patients with asymptomatic severe aortic stenosis, a strategy of early TAVR compared with clinical surveillance resulted in a significant reduction in the primary endpoint of death, stroke or unplanned CV hospitalization, and multiple endpoint variations demonstrated consistent results. […] At a median follow-up of 3.8 years, the primary endpoint of all-cause death, stroke or unplanned hospitalization for CV causes occurred in 26.8% of the TAVR group and 45.3% of the surveillance group.

• #42 Aortic Valve Replacement vs Clinical Surveillance in Asymptomatic Severe Aortic Stenosis: A Systematic Review and Meta-Analysis | CTSNet

  https://www.ctsnet.org/jans/aortic-valve-replacement-vs-clinical-surveillance-asymptomatic-severe-aortic-stenosis

  In this study-level meta-analysis of randomized controlled trials (RCTs) evaluating the effect of early aortic valve replacement (AVR) versus clinical surveillance (CS) in patients with asymptomatic severe aortic stenosis (AS), four RCTs were identified and included for analysis: AVATAR, RECOVERY, EARLY TAVR, EVOLVED. […] At an average follow-up time of 4.1 years, early AVR was associated with a significant reduction in unplanned cardiovascular or HF hospitalization (14.6 percent versus 31.9 percent; HR: 0.40; 95 percent CI: 0.30-0.53;P0.01) and stroke (4.5 percent versus 7.2 percent; HR: 0.62; 95 percent CI: 0.40-0.97;P=0.03). […] The authors conclude that early AVR is associated with a significant reduction in unplanned cardiovascular or HF hospitalization and stroke, but no difference in all-cause or cardiovascular mortality compared with CS.

• #43 Early transcatheter aortic valve replacement reduces cardiovascular events in asymptomatic aortic stenosis patients

  https://medicalxpress.com/news/2025-05-early-transcatheter-aortic-valve-cardiovascular.html

  New analysis from the EARLY TAVR trial showed patients between the age of 65 and 70 years old derived the most benefits of a strategy of early intervention with transcatheter aortic valve replacement (TAVR) compared to other age groups, especially in regards to stroke risk, and in regards to the composite of death, stroke, and heart failure hospitalization. […] As many as 300,000 Americans are diagnosed with AS each year, a serious condition that occurs when the aortic valve in the heart is narrowed or blocked. […] For patients with asymptomatic, severe AS, the EARLY TAVR trial demonstrated that a strategy of early TAVR was superior to CS for the primary endpoint of death, stroke, or unplanned cardiovascular hospitalization. […] Older age was associated with higher rates of death, stroke, or HF hospitalizations up to five years post-procedure for both patient groups. Early TAVR demonstrated benefits over CS across all age groups.

• #44 Early transcatheter aortic valve replacement reduces cardiovascular events in asymptomatic aortic stenosis patients

  https://medicalxpress.com/news/2025-05-early-transcatheter-aortic-valve-cardiovascular.html

  That said, patients aged 65–69 who underwent early TAVR derived the most benefits, with significant reduction in stroke risk (0% early TAVR vs. 13% CS) and had six times lower rate of death, stroke, or HF hospitalization compared to those who underwent CS (4.7% vs. 25.6%, respectively) up to five years post-procedure. […] „Taking all together, and given the benefits and the lack of risks in patients 65 years or greater, early TAVR should be preferred to clinical surveillance in all age groups,” said Philippe Genereux, MD, Director of the Structural Heart Program at the Gagnon Cardiovascular Institute at Morristown Medical Center, in Morristown, New Jersey, Principal Investigator of the EARLY TAVR trial, and lead author of the study.

• #45 Early transcatheter aortic valve replacement reduces cardiovascular events in asymptomatic aortic stenosis patients

  https://medicalxpress.com/news/2025-05-early-transcatheter-aortic-valve-cardiovascular.html

  That said, patients aged 65–69 who underwent early TAVR derived the most benefits, with significant reduction in stroke risk (0% early TAVR vs. 13% CS) and had six times lower rate of death, stroke, or HF hospitalization compared to those who underwent CS (4.7% vs. 25.6%, respectively) up to five years post-procedure. […] „Taking all together, and given the benefits and the lack of risks in patients 65 years or greater, early TAVR should be preferred to clinical surveillance in all age groups,” said Philippe Genereux, MD, Director of the Structural Heart Program at the Gagnon Cardiovascular Institute at Morristown Medical Center, in Morristown, New Jersey, Principal Investigator of the EARLY TAVR trial, and lead author of the study.

• #46 AVR for Moderate Aortic Stenosis

  https://consultqd.clevelandclinic.org/aortic-valve-replacement-for-moderate-aortic-stenosis-saves-lives-in-cohort-study

  However, over the past several years, multiple studies have shown that moderate AS has a poorer prognosis than previously thought, with a clear increased risk of heart failure, cardiovascular mortality and all-cause mortality. […] Overall, 363 patients (25.5%) died during follow-up. Among them, 266 deaths (18.7% of the overall cohort) were classified as cardiovascular deaths. […] Comparisons between the AVR and clinical surveillance groups revealed that intervention was associated with a lower risk of all-cause death (adjusted hazard ratio [HR] = 0.51; 95% CI, 0.34-0.77; P = .001) and cardiovascular death (adjusted HR = 0.50; 95% CI, 0.31-0.80; P = .004). […] Improved echocardiographic findings were also evident in patients who underwent AVR. In multivariable-adjusted analysis, they had significantly higher LVEF and lower right ventricular systolic pressure over time than patients managed with clinical surveillance, who worsened in both of those parameters over the study period.

• #47 AVR for Moderate Aortic Stenosis

  https://consultqd.clevelandclinic.org/aortic-valve-replacement-for-moderate-aortic-stenosis-saves-lives-in-cohort-study

  Patients who undergo aortic valve replacement (AVR) for moderate aortic stenosis (AS) fare better, on average, than comparable patients managed with clinical surveillance, with significant improvements seen in survival and left ventricular remodeling over multiyear follow-up. […] We found a significant advantage to replacing the aortic valve in patients with moderate AS rather than waiting until symptoms became severe, says senior and corresponding study author Samir Kapadia, MD, Chair of Cardiovascular Medicine at Cleveland Clinic. Increasing evidence indicates that intervention is a promising alternative to conservative management in the setting of moderate AS. […] AS, increasingly seen in an aging population, is not treated with AVR per current guidelines except in patients with severe symptomatic disease or evidence of left ventricular systolic dysfunction, or in those with moderate AS who are undergoing open-heart surgery for another indication.

• #48 AVR for Moderate Aortic Stenosis

  https://consultqd.clevelandclinic.org/aortic-valve-replacement-for-moderate-aortic-stenosis-saves-lives-in-cohort-study

  However, over the past several years, multiple studies have shown that moderate AS has a poorer prognosis than previously thought, with a clear increased risk of heart failure, cardiovascular mortality and all-cause mortality. […] Overall, 363 patients (25.5%) died during follow-up. Among them, 266 deaths (18.7% of the overall cohort) were classified as cardiovascular deaths. […] Comparisons between the AVR and clinical surveillance groups revealed that intervention was associated with a lower risk of all-cause death (adjusted hazard ratio [HR] = 0.51; 95% CI, 0.34-0.77; P = .001) and cardiovascular death (adjusted HR = 0.50; 95% CI, 0.31-0.80; P = .004). […] Improved echocardiographic findings were also evident in patients who underwent AVR. In multivariable-adjusted analysis, they had significantly higher LVEF and lower right ventricular systolic pressure over time than patients managed with clinical surveillance, who worsened in both of those parameters over the study period.

• #49 AVR for Moderate Aortic Stenosis

  https://consultqd.clevelandclinic.org/aortic-valve-replacement-for-moderate-aortic-stenosis-saves-lives-in-cohort-study

  Both TAVR and SAVR groups demonstrated significant benefit over clinical surveillance. […] Our study findings, especially in light of treatment advances and increased understanding of the poor prognosis associated with moderate AS, make us more inclined to offer intervention to our patients earlier in the disease process, Dr. Kapadia concludes. […] It has become clear in a number of studies, he continues, that patients undergoing AVR do not always enjoy the survival benefit expected. This paper provides further insights into this phenomenon and raises the question of whether AVR should be performed at an earlier stage, at least at centers with outstanding procedural outcomes for SAVR and TAVR. […] Given these important findings, intervening on moderate AS seems justified, and using safe, minimally invasive techniques to improve patient experience and outcomes may help avoid progression of heart failure due to AS.

• #50 Establishing an aortic stenosis surveillance clinic – The British Journal of Cardiology

  https://bjcardio.co.uk/2010/11/establishing-an-aortic-stenosis-surveillance-clinic/

  The number of patients with aortic stenosis (AS) in the UK is increasing. […] Establishment of a national AS surveillance programme could result in a large number of patients (9,000) being discharged from formal doctor-led cardiology clinic review in the UK. This would improve quality and consistency of follow-up monitoring for the patient and free up capacity to see new patients. […] Aortic stenosis (AS) is the most common form of valvular heart disease. The incidence is increasing due to an ageing population. […] Within the UK, demand for specialist cardiology services continues to increase. […] An AS surveillance clinic can result in a modest reduction in patients attending the cardiology out-patient department. […] Widespread national implementation of such clinics should be considered.

• #51 Diagnostic Challenges in Aortic Stenosis

  https://www.mdpi.com/2308-3425/11/6/162

  However, several investigations have demonstrated that this is a simplistic approach. […] A multimodality cardiac imaging approach (MCI) plays a key role in these scenarios. […] The addition of complementary techniques such as transesophageal echocardiography (TEE), multidetector computed tomography (MDCT), and cardiac magnetic resonance (CMR) allows a proper grading in most cases. […] The objective of this review is to delve into the MCI used in the assessment of AS, highlighting the usefulness, strengths, and weaknesses of each imaging test, particularly in specific cases in which the grading of the disease is challenging. […] In many cases, severe aortic stenosis is not a straightforward diagnosis. […] In all these challenging scenarios, multimodality cardiac imaging can lead to a higher precision grading and a better decision-making process.

• #52 Diagnostic Challenges in Aortic Stenosis

  https://www.mdpi.com/2308-3425/11/6/162

  However, several investigations have demonstrated that this is a simplistic approach. […] A multimodality cardiac imaging approach (MCI) plays a key role in these scenarios. […] The addition of complementary techniques such as transesophageal echocardiography (TEE), multidetector computed tomography (MDCT), and cardiac magnetic resonance (CMR) allows a proper grading in most cases. […] The objective of this review is to delve into the MCI used in the assessment of AS, highlighting the usefulness, strengths, and weaknesses of each imaging test, particularly in specific cases in which the grading of the disease is challenging. […] In many cases, severe aortic stenosis is not a straightforward diagnosis. […] In all these challenging scenarios, multimodality cardiac imaging can lead to a higher precision grading and a better decision-making process.

• #53 Diagnostic Challenges in Aortic Stenosis

  https://www.mdpi.com/2308-3425/11/6/162

  However, several investigations have demonstrated that this is a simplistic approach. […] A multimodality cardiac imaging approach (MCI) plays a key role in these scenarios. […] The addition of complementary techniques such as transesophageal echocardiography (TEE), multidetector computed tomography (MDCT), and cardiac magnetic resonance (CMR) allows a proper grading in most cases. […] The objective of this review is to delve into the MCI used in the assessment of AS, highlighting the usefulness, strengths, and weaknesses of each imaging test, particularly in specific cases in which the grading of the disease is challenging. […] In many cases, severe aortic stenosis is not a straightforward diagnosis. […] In all these challenging scenarios, multimodality cardiac imaging can lead to a higher precision grading and a better decision-making process.

• #54 FDA Approves Sapien 3 TAVR for Asymptomatic Aortic Stenosis | MedPage Today

  https://www.medpagetoday.com/cardiology/pci/115375

  FDA approved the Sapien 3 transcatheter aortic valve replacement (TAVR) platform for treatment of severe aortic stenosis early in the disease process while patients still had no symptoms or other indication for aortic valve replacement, marking the first approval for TAVR in asymptomatic patients, Edwards Lifesciences announced today. […] TAVR is well established for severe aortic stenosis patients with symptoms across surgical risk categories, but guidelines recommend routine monitoring every 6 to 12 months for asymptomatic patients. […] „There is an urgent need to change practice and TAVR guidelines for the treatment of aortic stenosis patients, which currently recommend 'watchful waiting’ until symptoms develop,” according to a statement from EARLY TAVR lead author Philippe Genereux, MD, director of the structural heart program at Gagnon Cardiovascular Institute in Morristown, New Jersey.

• #55 FDA Approves Sapien 3 TAVR for Asymptomatic Aortic Stenosis | MedPage Today

  https://www.medpagetoday.com/cardiology/pci/115375

  FDA approved the Sapien 3 transcatheter aortic valve replacement (TAVR) platform for treatment of severe aortic stenosis early in the disease process while patients still had no symptoms or other indication for aortic valve replacement, marking the first approval for TAVR in asymptomatic patients, Edwards Lifesciences announced today. […] TAVR is well established for severe aortic stenosis patients with symptoms across surgical risk categories, but guidelines recommend routine monitoring every 6 to 12 months for asymptomatic patients. […] „There is an urgent need to change practice and TAVR guidelines for the treatment of aortic stenosis patients, which currently recommend 'watchful waiting’ until symptoms develop,” according to a statement from EARLY TAVR lead author Philippe Genereux, MD, director of the structural heart program at Gagnon Cardiovascular Institute in Morristown, New Jersey.

• #56 FDA Approves SAPIEN 3 Platform for Asymptomatic Severe Aortic StenosisCalifornia Consumer Privacy Act (CCPA) Opt-Out Icon

  https://www.usnews.com/news/health-news/articles/2025-05-05/fda-approves-sapien-3-platform-for-asymptomatic-severe-aortic-stenosis

  FDA Approves SAPIEN 3 Platform for Asymptomatic Severe Aortic Stenosis. The U.S. Food and Drug Administration has approved the SAPIEN 3 platform, a transcatheter aortic valve replacement (TAVR) therapy, for patients with severe aortic stenosis without symptoms. The approval is the first for TAVR in asymptomatic patients. In the EARLY TAVR trial, which informed the approval, patients with asymptomatic severe aortic stenosis were randomly assigned to either TAVR or watchful waiting. During a median follow-up of 3.8 years, 26.8 percent of the 455 patients in the TAVR group experienced death, stroke, or unplanned cardiovascular hospitalization compared with 45.3 percent of the 446 patients in the clinical surveillance group. […] „There is an urgent need to change practice and TAVR guidelines for the treatment of aortic stenosis patients, which currently recommend 'watchful waiting’ until symptoms develop,” Philippe Genereux, M.D., from the Gagnon Cardiovascular Institute at Morristown Medical Center in New Jersey, said in a statement. „As we saw in the EARLY TAVR trial, patients originally designated as asymptomatic became symptomatic in sudden and unpredictable ways, underscoring the importance of early evaluation by a heart team to improve patient outcomes and benefit the health care system.”

• #57 FDA Approves SAPIEN 3 Platform for Asymptomatic Severe Aortic StenosisCalifornia Consumer Privacy Act (CCPA) Opt-Out Icon

  https://www.usnews.com/news/health-news/articles/2025-05-05/fda-approves-sapien-3-platform-for-asymptomatic-severe-aortic-stenosis

  FDA Approves SAPIEN 3 Platform for Asymptomatic Severe Aortic Stenosis. The U.S. Food and Drug Administration has approved the SAPIEN 3 platform, a transcatheter aortic valve replacement (TAVR) therapy, for patients with severe aortic stenosis without symptoms. The approval is the first for TAVR in asymptomatic patients. In the EARLY TAVR trial, which informed the approval, patients with asymptomatic severe aortic stenosis were randomly assigned to either TAVR or watchful waiting. During a median follow-up of 3.8 years, 26.8 percent of the 455 patients in the TAVR group experienced death, stroke, or unplanned cardiovascular hospitalization compared with 45.3 percent of the 446 patients in the clinical surveillance group. […] „There is an urgent need to change practice and TAVR guidelines for the treatment of aortic stenosis patients, which currently recommend 'watchful waiting’ until symptoms develop,” Philippe Genereux, M.D., from the Gagnon Cardiovascular Institute at Morristown Medical Center in New Jersey, said in a statement. „As we saw in the EARLY TAVR trial, patients originally designated as asymptomatic became symptomatic in sudden and unpredictable ways, underscoring the importance of early evaluation by a heart team to improve patient outcomes and benefit the health care system.”

• #58 Sex-related disparities in aortic stenosis from disease awareness to treatment: a state-of-the-art review – Appleby – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/90835/html

  Therefore, it is paramount that awareness amongst physicians of the sex-related disparities in treating severe AS is raised to abolish the current healthcare gap between the sexes. […] Compared to men, women with severe AS are more symptomatic, older, frailer, have lower body mass index (BMI), exhibit higher operative risk, and often belong to New York Heart Association (NYHA) class III/IV. […] In women, SAVR may be technically more demanding and complicated due to sex-specific pathophysiological differences, such as smaller annular sizes and LVOT dimensions linked to concentric LVH. […] Despite significant advancements in TAVR procedures, disparities in outcomes, including mortality rates between male and female patients, exist. […] Therefore, careful consideration and appropriate antithrombotic therapies should be employed to prevent thrombotic complications.

• #59 Aortic stenosis and transcatheter aortic valve implantation in the elderly

  https://www1.racgp.org.au/ajgp/2023/july/aortic-stenosis-and-transcatheter-aortic-valve-imp

  Owing to an aging population there is a growing prevalence of severe AS in Australia. […] Severe AS without valvular intervention is associated with a poor prognosis. […] GPs are paramount in identifying patients with severe AS and facilitating timely diagnosis and treatment. […] TAVI is now a well-established procedure that enables treatment for severe AS in the elderly. […] TAVI is associated with a reduced hospital stay, expedited recovery and improved quality of life.

• #60 Target: Aortic Stenosis Resources for Healthcare Professionals | American Heart Association

  https://www.heart.org/en/professional/quality-improvement/target-aortic-stenosis/resources-for-healthcare-professionals

  The Target: Aortic Stenosis quality improvement program exists to enhance the patient experience from symptom onset to appropriate diagnosis and follow-through, to timely treatment and disease management. […] Identification of patients diagnosed with moderate or severe aortic stenosis. […] Need for routine surveillance. […] Delay in referral directly impacts survival rates.

• #61 Target: Aortic Stenosis Resources for Healthcare Professionals | American Heart Association

  https://www.heart.org/en/professional/quality-improvement/target-aortic-stenosis/resources-for-healthcare-professionals

  The Target: Aortic Stenosis quality improvement program exists to enhance the patient experience from symptom onset to appropriate diagnosis and follow-through, to timely treatment and disease management. […] Identification of patients diagnosed with moderate or severe aortic stenosis. […] Need for routine surveillance. […] Delay in referral directly impacts survival rates.

• #62

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