Association Between the Degree of Extravalvular Cardiac Damage and the Severity of Aortic Stenosis

doi:10.1016/j.jacadv.2026.103227

Valvular & structural heart diseaseCohort study

Association Between the Degree of Extravalvular Cardiac Damage and the Severity of Aortic Stenosis

JACC AdvPublished 10 Sep 2026

cohort
regionwide
consecutive patients
117 cardiologists
5-year follow-up

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Authors' conclusion

The extent of extravalvular CD correlates with AS severity and is associated with poor clinical outcomes across all AS stages. Further research is warranted to determine whether assessing CD should be integrated in the management of patients with AS.

Study context

Population: Outpatients with mild, moderate or severe native aortic stenosis (AS) in the VALVENOR cohort, May 2016 to December 2017patients with available cardiac damage (CD) (65% of the overall cohort) · mild AS 744 · moderate AS 714 · severe AS 289
Participants: 1,747 outpatients

Exposure: patients in stage >0 as compared with patients in stage 0
stage 0n = 524reference

Main finding

As reported in the abstract

Distribution of AS severity

mild AS42.6%744 events

moderate AS40.9%714 events

severe AS16.5%289 events

Observational data: associations, not effects.

Further findings

Peak aortic jet velocity · higher in stage >0

P < 0.001

stage >03.35 ± 0.69 m/s

stage 03.11 ± 0.56 m/s

Outcome	Lower risk with stage >0 ←→ Higher risk with stage >0	HR (95% CI)	P value
All-cause mortality		1.75 (1.44–2.11)	P < 0.001
Cardiovascular mortality		2.52 (1.79–3.55)	P < 0.001
	0.20.5125Hazard ratio (log scale)

Outcome	stage >0	stage 0	Estimate	P value
Distribution of CD stage	Not reported in the abstract	30%

Distribution of CD stage: stage 1 17%
Distribution of CD stage: stage 2 44%
Distribution of CD stage: stage 3 6%
Distribution of CD stage: stage 4 3%

Independent association of peak aortic jet velocity with CD stage >0

higher peak aortic jet velocity (per m/s) remained independently associated with CD stage >0: P < 0.001

After adjustment

Original publication

Association Between the Degree of Extravalvular Cardiac Damage and the Severity of Aortic Stenosis. JACC Adv. Published 10 September 2026. doi:10.1016/j.jacadv.2026.103227

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Summarised from the published abstract; every number is checked against it