June 9, 2025Circulation
New Classification to Describe Clinical Presentation in Aortic Stenosis: Stable, Progressive, and Acute Valve Syndrome
Key result
New classification categorizes aortic stenosis into stable, progressive, and acute valve syndromes reflecting variable progression.
Key Points
- To introduce a novel clinical classification system categorizing aortic stenosis into stable, progressive, and acute valve syndromes based on variability in disease trajectory.
- Evaluated clinical presentation patterns and rates of disease progression in patients with aortic stenosis.
- Characterized biological and pathological drivers, including genetics, lipoprotein deposition, lipid oxidation, and active inflammation.
- Established three clinical presentation categories—stable, progressive, and acute valve syndrome—to reflect pronounced interindividual variability in hemodynamic deterioration.
- Highlighted the interplay of lipid accumulation, oxidative stress, and chronic inflammatory pathways as primary mechanisms accelerating valvular remodeling.
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“These findings provide a strong rationale for prompt intervention in patients with asymptomatic severe aortic stenosis at least to prevent progression to acute valve syndrome and poor outcome.”
RORobert O. BonowCardiologist, Northwestern University Feinberg School of Medicine
“These patients already had their TAVR. So, [is] this related somewhat to the device that may have been used? The operators? The patients themselves? How do you explain that higher stroke risk?”
Implication
Clinical review proposes a phenotypic classification in aortic stenosis, highlighting variable progression and complex underlying pathophysiology.
Abstract
ortic stenosis (AS) is a progressive disease characterized by important interindividual variability in the rate of disease progression. The pathophysiology of AS progression is complex and involves multiple mechanisms such as genetics, lipoprotein deposition and oxidation, inflammation
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Cite This Study
Généreux et al. (2025) studied this question. A new classification system categorizes aortic stenosis clinical presentation into stable, progressive, and acute valve syndrome to account for interindividual variability in disease progression.