Key result
Non-invasive exercise testing identifies high-risk asymptomatic severe AS patients warranting early AVR.
Why the study?
Does early aortic valve replacement improve outcomes compared to conservative management in high-risk patients with asymptomatic severe aortic stenosis and normal left ventricular function?
Does early aortic valve replacement improve outcomes compared to conservative management in high-risk patients with asymptomatic severe aortic stenosis and normal left ventricular function?
This review highlights the role of non-invasive testing in identifying high-risk patients with asymptomatic severe aortic stenosis who may benefit from early aortic valve replacement.
Answers are grounded in this paper and cite their sources.
Supports non-invasive risk stratification in asymptomatic severe AS; leaves open whether early AVR improves outcomes.
Aortic stenosis (AS) is one of the commonest forms of acquired valvular heart disease. Aortic valve replacement (AVR) is the treatment of choice for symptomatic severe AS. Conservative management is usually advocated for asymptomatic severe AS. But there are data on predictors to identify subsets of asymptomatic AS patients at high risk of cardiac events in whom early surgical intervention is warranted. Non-invasive tests like exercise stress test, exercise echocardiography will help us to identify those who are at high risk of developing early symptoms due to LV dysfunction and also those at high risk of sudden death. In this article, an attempt is made to review the literature on this subset of asymptomatic severe AS to help clinicians to decide regarding the need for early aortic valve replacement in them.
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Sathyamurthy et al. (2016) conducted a review in Asymptomatic severe aortic stenosis with normal left ventricular function. Early aortic valve replacement / Non-invasive tests vs. Conservative management was evaluated. Non-invasive tests like exercise stress testing and exercise echocardiography can identify subsets of asymptomatic severe aortic stenosis patients at high risk of cardiac events who warrant early AVR.
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