Valvular & structural heart diseaseResearch article
Clinical outcomes and haemodynamic response after blinded stress assessment of moderate aortic stenosis
- pilot study
- prospectively enrolled
- Stress aortic valve index (SAVI) measured but blinded
- followed for ≥1 year
Authors' conclusion
Stress haemodynamic assessment in moderate AS unmasks a subgroup, not identified by conventional metrics, who are at significantly higher risk for AV intervention. Patients with abnormal stress physiology despite only moderate AS at rest may benefit from AV intervention, supporting this pilot study as the basis for a future randomised trial.
Study context
- Population
- Symptomatic patients with moderate aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF) without an alternative explanation for symptomspatients prospectively enrolled
- Participants
- 52 patients
- Comparison
- Stress aortic valve index (SAVI) against echocardiographic parameters of AS severity and clinical outcomes
Main finding
As reported in the abstract
Invasive transvalvular gradient · at rest and during dobutamine
at rest
25±9 mmHg
during dobutamine
42±14 mmHg
Further findings
| Outcome | hazard ratio | P value |
|---|---|---|
| Need for clinical aortic valve (AV) intervention | 5.7 | P = 0.007 |
- Need for clinical aortic valve (AV) intervention: independent predictor; Aortic valve area (AVA) and sex-specific calcium thresholds did not predict
Aortic-to-left ventricular pressure ratio · at rest and under stress
- at rest
- 0.82 (interquartile range [IQR] 0.78-0.88)
- SAVI under stress
- 0.70 (IQR 0.63-0.79)
Resting aortic valve area (AVA) and stress haemodynamics
- Resting AVA did not predict stress haemodynamics
Patients with SAVI ≤0.70
- patients with SAVI ≤0.70
- 25/52 (48%)
- comparable with a severe AS cohort studied separately
Original publication
Clinical outcomes and haemodynamic response after blinded stress assessment of moderate aortic stenosis. EuroIntervention. Published 16 March 2026. doi:10.4244/eij-d-25-01006
Summarised from the published abstract; every number is checked against it