Asymptomatic, hemodynamically significant aortic stenosis carries a high rate of symptom progression within 5 years and a 1% annual risk of sudden death.
Supports vigilant monitoring in asymptomatic severe AS; hypothesis-generating for intervention thresholds without randomized confirmation.
Most patients with asymptomatic, hemodynamically significant AS will develop symptoms within 5 years. Sudden death occurs in approximately 1%/y. Age, chronic renal failure, inactivity, and aortic valve velocity are independently predictive of all-cause mortality.
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Pellikka et al. (2005) studied this question.
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