Valvular & structural heart diseaseCohort study
Subvalvular aortic stenosis in adults: clinical course and long-term outcomes
- Prospective registry cohort study
- CONCOR registry
- 2001-2019
Authors' conclusion
Survival of adult SAS patients with a history of SAS repair was substantially lower compared to the unoperated group, reflecting a potentially more severe SAS phenotype. Nevertheless, long-term clinical event rates were considerable. SAS remained stable, suggesting less echocardiographic follow-up may suffice, particularly in mild phenotypes without AR.
Study context
- Population
- Adults with subvalvular aortic stenosis (SAS) in the Dutch CONCOR registrymedian follow-up 16 years
- Participants
- 312 adults
- Exposure
- Operated vs unoperated SAS; isolated vs non-isolated SAS; men vs women
- Outcome
- All-cause mortality, SAS (re-)operation and CV events (arrhythmias, HF, (re-)operation for aortic regurgitation)
Main finding
As reported in the abstract
No significant survival difference between sexes
P = .083
No significant survival difference isolated vs non-isolated SAS
P = .810
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| SAS repair during follow-up · hazard higher in unoperated; adjusted for covariates | 0.2 (0.1–0.5) | P < 0.001 | |
| 0.10.31310Hazard ratio (log scale) |
Cumulative incidence of (re-)operation for aortic regurgitation (AR) · 15 years
- Cumulative incidence
- 7.6% (95% CI 4.7%-11.0%)
Peak velocity progression
- First period
- 0.1 m/s (P = .357)
- Second period (after ±10 years)
- 0.3 m/s (P = .032)
- Patients with fast progression (≥0.3 m/s/year)
- 0
LV hypertrophy at baseline (interventricular septal thickness (IVST)/LVPW criteria)
- No evidence of LV hypertrophy
Original publication
Summarised from the published abstract; every number is checked against it