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February 19, 2026Journal of Clinical MedicineOpen Access

Evolution of Cardiac Damage Across Clinically Defined Stages of Aortic Stenosis in Patients Undergoing TAVR: A Single-Center Retrospective Cohort Study

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Why the study?

Cardiac damage staging systems may better characterize myocardial and extracardiac involvement, prompting evaluation of cardiac damage presence and progression across the clinical course of AS.

Does echocardiographic cardiac damage progress across clinically defined stages of aortic stenosis prior to TAVR?

Population

179 consecutive TAVR patients with serial echocardiograms across AS stages

Comparison

Moderate AS vs first severe AS vs pre-TAVR symptomatic severe AS

Design

Single-center retrospective cohort study

Follow-up

Median 32 months from moderate to severe AS

Key result

LV GLS worsened from -18.1% to -14.9% and RVAc declined from 1.0 to 0.7 as AS progressed to severe stages, independent of symptoms (p < 0.05).

Authors

MRMaría Rivadeneira-RuizCOCarmen OlmosSGS Gil-Abizanda

Discussion

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Member takes

Overview

May support GLS/RVAc for early AS risk stratification; hypothesis-generating pending prospective validation.

Key Points

  • This study evaluates the progression of cardiac damage across different clinical stages of aortic stenosis (AS).
  • Conducted a single-center retrospective cohort study.
  • Included patients who underwent TAVR with serial echocardiograms at moderate AS, first severe AS, and pre-TAVR symptomatic severe AS.
  • Evaluated a total of 179 patients with established cardiac damage staging systems.
  • Median time from moderate to severe AS was 32 months.
  • Echocardiographic parameters mainly deteriorated at symptom onset.
  • Left ventricular global longitudinal strain (LV GLS) was already impaired at first severe AS stage.
  • Right ventricular–arterial coupling (RVAc) worsened progressively with AS severity; statistically significant overall (p < 0.05).

Structured PICO

Does echocardiographic cardiac damage progress across clinically defined stages of aortic stenosis prior to TAVR?

P
Population
179 consecutive patients who ultimately underwent TAVR and had retrievable serial echocardiograms at moderate AS, first severe AS, and pre-TAVR symptomatic severe AS. Mean age 82.7 years, 46% male.
I
Intervention
Serial echocardiographic assessment of cardiac damage (using two established staging systems, LV GLS, and RVAc) at moderate AS, first severe AS, and pre-TAVR symptomatic severe AS
O
Outcome
Presence and progression of cardiac damage across the clinical course of AS, assessed by echocardiographic parameters including LV GLS and RVAcsurrogate

Echocardiographic markers of cardiac damage, such as LV GLS and RV-arterial coupling, worsen early in the progression of aortic stenosis before symptom onset, suggesting their utility in early risk stratification.

Cite This Study

Rivadeneira-Ruiz et al. (2026) studied this question. LV GLS worsened from -18.1% to -14.9% and RVAc declined from 1.0 to 0.7 as AS progressed to severe stages, independent of symptoms (p < 0.05).

synapsesocial.com/papers/6996a8c7ecb39a600b3efd58https://doi.org/10.3390/jcm15041575
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