Key result
LVH, LA size, BNP, and GLS may identify asymptomatic severe AS patients warranting early AVR.
Why the study?
Does early intervention (aortic valve replacement) improve outcomes compared to watchful waiting in patients with asymptomatic but hemodynamically severe aortic stenosis?
Does early intervention (aortic valve replacement) improve outcomes compared to watchful waiting in patients with asymptomatic but hemodynamically severe aortic stenosis?
This review highlights variables and guidelines to help determine which patients with asymptomatic severe aortic stenosis should undergo early valve replacement.
Answers are grounded in this paper and cite their sources.
May refine risk stratification in asymptomatic severe aortic stenosis; leaves open whether early valve replacement improves outcomes.
Asymptomatic but hemodynamically severe aortic stenosis often poses a dilemma: should the aortic valve be replaced, or is watchful waiting acceptable? Patients with this condition are a diverse group with varying prognoses. Here, we review the guidelines for valve replacement in this situation and highlight the variables useful in establishing which patients should be considered for early intervention even if they have no symptoms.
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McCarthy et al. (2016) conducted a review in Asymptomatic aortic stenosis. Aortic valve replacement vs. Watchful waiting was evaluated. Novel assessment variables including left ventricular hypertrophy, left atrial size, B-type natriuretic peptide level, and global left ventricular longitudinal strain may help identify patients with asymptomatic severe aortic stenosis who warrant early aortic valve replacement.
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