The value of evaluating cardiac damage in patients with aortic stenosis: A systematic review.
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All Authors
Bennett, S.
Holroyd, E.
Paton, M.F.
Leeson, P.
Redfors, B.
Pibarot, P.
Genereux, P.
Kwok, C.S.
LTHT Author
Paton, Maria
LTHT Department
Cardio-Respiratory
Cardiology
Cardiology
Non Medic
Highly Specialist Cardiac Physiologist
Publication Date
2025
Item Type
Conference Abstract
Language
Subject
AORTIC VALVE STENOSIS , WOMEN , HEART INJURIES , MEN , META-ANALYSIS AS TOPIC , MORTALITY , RISK ASSESSMENT , RESEARCH DESIGN , SYSTEMATIC REVIEW AS TOPIC , HEART VALVE DISEASES
Subject Headings
Abstract
Background: Aortic stenosis (AS) is a common valvular heart disease. A novel scoring system based on 'cardiac damage' has been proposed recently that characterises pathophysiological consequences of AS into different stages. This staging system may be useful for assessment of risk and prognosis in patients with AS to guide treatment. Method(s): We conducted a systematic review of studies which evaluated 'cardiac damage' in patients with AS to assess its value in identifying high risk patients. A search of MEDLINE and EMBASE was performed in January 2024 with data being extracted from relevant studies. Studies were pooled numerically or in meta-analysis. Result(s): A total of 18 studies were included with 21,876 patients (mean age 79 years, 52.7% males). For patients who underwent any AVR the pooled mortality for stage 0, 1, 2, 3 and 4 was 5.3% (6/114), 6.8% (22/325), 11.9% (118/995), 18.9% (92/486) and 21.6% (35/162), respectively. For patients with transcatheter AVR, the pooled mortality rate was 8.41% for stage 0 (96/1141), 17.08% for stage 1 (218/1276), 23.30% for stage 2 (624/2678), 32.46% for stage 3 and 36.47% for stage 4 (349/957). In comparison to stage 0, the odds risk (OR) of mortality for stage 1: OR 1.50 95%CI 1.14-1.98, stage 2: OR 1.77 95%CI 1.37-2.29, stage 3: OR 2.99 95%CI 2.28-3.94 and stage 4: OR 3.82 95%CI 2.68-5.44. Conclusion(s): Assessment of 'cardiac damage' stage has strong prognostic value for patients with AS who require AVR.
Journal
Echo Research and Practice