Studies evaluating the natural history of moderate aortic stenosis
| Author | Studies of outcomes in patients with moderate aortic stenosis | |||||||
| Years | N | Echo/cath | AV parameter | LVEF, % (mean) | Symptoms during follow-up | Follow-up time | Outcomes (mortality or event-free survival) | |
| Chizner26 | 1966–1971 | 10 | Cath | AVA: 0.71–1.09 cm2 and MPG: <70 mm Hg | NR | Heart failure, angina, syncope | 64 months | 57% at 3 years (mortality) |
| Turina27 | 1963–1983 | 30 | Cath | AVA: 0.95–1.4 cm2 | NR | Dyspnea | 10 years | 35% at 10 years (event-free survival from AVR and death) |
| Kennedy28 | 1980–1985 | 66 | Cath | AVA: 0.7–1.2 cm2 | 55 | Dyspnea | 4 years | 59% at 4 years (event-free survival from AVR and death) |
| Horstkotte and Loogen29 | 1978–1988 | 236 | Cath | AVA: 0.8–1.5 cm2 | NR | Heart failure | 16 years | 65% at 8 years (event-free survival from AVR) |
| Livanaienen | 1990–1991 | 26 | Echo | AVA: 0.9–1.2 cm2 | NR | Angina, syncope dyspnea | 4 years | 50% at 4 years (mortality) |
| Kearney22 | 1988–1994 | 55 | Echo | AVA: 1.0–1.5 cm2 or MPG: 25–40 mm Hg | NR | NR | 6.5 years | 23% at 5 years (event-free survival from AVR and death) |
| Roshenhek | 1994 | 176 | Echo | Vmax: 2.5–3.9 m/s | >50 | Dyspnea | 5 years | 42% at 5 years (event-free survival from AVR and death) |
| Otto20 | 1989–1995 | 68 | Echo | Vmax: 3.0–4.0 m/s | >65 | Angina, heart failure, syncope | 2.5 years | 66% at 2 years (event-free survival from AVR) |
| Minners | 2001–2002 | 948 | Echo | Vmax: 3.0–4.0 m/s | 66 | NR | 5 years | 49% at 5 years (event-free survival from AVR and death) |
| Yechoor | 2006 | 104 | Echo | AVA: 1.0–1.5 cm2 | 49 | NR | 5 years | 15% at 5 years (event-free survival from AVR and death) |
| Samad25 | 1995–2014 | 1090 | Echo | MPG: 25–40 mm Hg | <50 | Heart failure | 5 years | 74% at 5 years (event-free survival from AVR) |
| Delesalle6 | 2000–2014 | 508 | Echo | AVA: 1.0–1.5 cm2 | 64 | Dyspnea, angina, syncope | 6 years | 53% at 6 years (mortality) |
| Lancellotti7 | 2001–2014 | 514 | Echo | AVA: 1.0–1.5 cm2 | 66 | NR | 8 years | 78% at 8 years (mortality) |
| van Gils8 | 2010–2015 | 305 | Echo | AVA: 1.0–1.5 cm2 | <50 | NYHA class III/IV symptoms | 4 years | 39% at 4 years (event-free survival from AVR, death, HF hospitalization) |
| Mann19 | 2011–2016 | 952 | Echo | AVA: 1.0–1.5 cm2 | 55 | NR | 5 years | 66% at 5 years (mortality) |
| Tastet | 1998–2017 | 285 | Echo | AVA: >1.0 cm2 | >50 | Remained asymptomatic | 8 years | 32% at 6 years (mortality) |
| Murphy9 | 2014–2017 | 151 | Echo | Vmax: 3.0–4.0 m/s, MPG: 20–30 mm Hg and AVA: 1.0–1.5 cm2 | >50 | NR | 50 months | 34% at 1 year (event-free survival from AVR, death, HF hospitalization) |
| Strange10 | 2000–2017 | 3315 | Echo | MPG: 20.0–29.9 mm Hg or Vmax: 3.0–3.9 m/s | 63 | NR | 5 years | 56% at 5 years (mortality) |
Displayed is a compiled list of studies evaluating the outcomes of moderate AS. Listed are the authors, enrolment dates, number of included individuals (N), modality for defining AS severity (echocardiography versus catheterisation), AV parameter used to define AS severity, mean LVEF of included patients, symptoms developed during follow up, follow-up time and outcomes (reported as either mortality or event-free survival from AVR, death, HF hospitalization or a combination).
AV, aortic valve; AVA, aortic valve area; AVR, aortic valve replacement; HF, heart failure; LVEF, left ventricular ejection fraction; MPG, mean pressure gradient; NR, not recorded; NYHA, New York Heart Association; Vmax, maximal aortic jet velocity.