Cardiac Damage Staging, Moderate Aortic Stenosis, and the Impact of Aortic Valve Replacement

作者：Evan Harmon, Travis Howard, Larisa G. Tereshchenko, Amar Krishnaswamy, Grant W. Reed, Elizabeth Ghandakly, James Yun, Marijan Koprivanac, Ankur Kalra, Serge C. Harb, Samir Kapadia, Rishi Puri · 发表于：JACC Advances · 年份：2025 · DOI：10.1016/j.jacadv.2025.102348 · 被引用次数：3 · 研究领域：Cardiac Valve Diseases and Treatments、Mechanical Circulatory Support Devices、Atrial Fibrillation Management and Outcomes

BACKGROUND: Cardiac damage stage predicts clinical outcomes in severe aortic stenosis (AS), yet its validation in moderate AS and natural history preaortic valve replacement (AVR) and post-AVR is poorly understood. OBJECTIVES: This paper sought to: 1) determine whether index cardiac damage stage predicts cardiovascular outcomes in patients with moderate AS; and 2) describe the impact of AVR on cardiac damage stage over time. METHODS: This retrospective single-center cohort study stratified patients with moderate AS according to index cardiac damage stage. We assessed whether cardiac damage stage predicted a primary composite outcome of all-cause death and heart failure (HF) hospitalization and a secondary outcome of AVR. Changes in stage over time were also assessed. RESULTS: < 0.001). The net result of awaiting AVR (median time 3.1 years) was an accumulation of cardiac damage, which partially resolved at 1-year. CONCLUSIONS: Cardiac damage stage is associated with an increasing risk of all-cause mortality and HF hospitalization in patients with moderate AS. The degree of damage accumulates as patients await AVR, which partially recovers post-AVR.