Valvular & structural heart diseaseCohort study
Evaluation, treatment, and outcomes in patients with possible severe aortic stenosis
- Retrospective analysis
- Duke Echocardiography Laboratory Database
Authors' conclusion
Patients with possible severe AS represent a high-risk population with substantial variation in confirmatory testing and AVR utilization, including differences across patient characteristics and provider factors.
Study context
- Population
- Individuals undergoing an echocardiogram between 2016 and 2024 with possible severe aortic stenosis (AS) (aortic valve area (AVA) <1.0 cm², mean aortic valve gradient ≥40 mmHg, or peak aortic velocity ≥4.0 m/s)possible severe AS, of 114,171 unique individuals who underwent echocardiography · possible low-gradient severe AS 1,764
- Participants
- 3,220 individuals
- Exposure
- Aortic valve replacement (AVR) vs possible low-gradient severe AS
- AVRn = 1,452
- possible low-gradient severe ASn = 1,764
Main finding
As reported in the abstract
Confirmatory testing in possible low-gradient severe AS · 1-year
possible low-gradient severe AS
18.1%
Observational data: associations, not effects.
Further findings
1-year mortality
| Comparison | hazard ratio (95% CI) | |
|---|---|---|
| AVR | 0.46 (0.37–0.57) | |
| 0.20.5125Hazard ratio (log scale) |
- 1-year mortality: AVR associated with lower 1-year mortality; comparator not printed
AVR · median of 1.4 years of follow-up
- Underwent AVR
- 1,452 (45.1%)
Predictors of AVR utilization
- Significant predictors: age <75, sex, advanced stage of cardiac damage, absence of symptoms, frailty, ordering provider and severity reported in the echocardiogram
Mortality and heart failure (HF) hospitalization rates (overall population)
per 100 person-years
- Mortality rate
- 17.6
- HF hospitalization rate
- 13.5
- higher in those with advanced cardiac stages and those with possible low-gradient severe AS
Original publication
Evaluation, treatment, and outcomes in patients with possible severe aortic stenosis. Am Heart J. Published 30 May 2026. doi:10.1016/j.ahj.2026.107498
Summarised from the published abstract; every number is checked against it