Moderate aortic stenosis carries a high morbidity and mortality, and evidence suggests that patients with left ventricular dysfunction may benefit from earlier intervention.
What is the natural history of moderate aortic stenosis and when should intervention be considered?
Moderate aortic stenosis, particularly when accompanied by left ventricular dysfunction, carries significant morbidity and mortality, suggesting a potential role for early intervention and multimodality imaging for risk stratification.
Current guidelines recommend aortic valve replacement in patients with severe aortic stenosis in the presence of symptoms or a left ventricular ejection fraction <50%. However, patients with less than severe aortic stenosis may also experience symptoms and recent literature suggests that the prognosis is not as benign as previously reported. There are no recommendations for patients with moderate aortic stenosis and left ventricular dysfunction, despite the high associated morbidity and mortality. There is also some evidence that these patients may benefit from early aortic valve intervention. It is recognised that aortic stenosis not only affects the valve but also has a complex myocardial response. This review discusses the natural history of moderate aortic stenosis along with the role of multimodality imaging in risk stratification in these patients.
Badiani et al. (Thu,) conducted a review in Moderate Aortic Stenosis. Moderate aortic stenosis carries a high morbidity and mortality, and evidence suggests that patients with left ventricular dysfunction may benefit from earlier intervention.