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editorial

. 2019 Feb 2;8(3):e011724. doi: 10.1161/JAHA.118.011724

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© 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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Mortality analysis of 785 asymptomatic patients (mean age 73 years, 53% males) with severe AS (AVA <1 cm²), preserved ejection fraction (LVEF ≥ 50%), and low surgical risk (EuroSCORE II ≤4%) managed medically and surgically in 3 European centers (Amiens, France; Lille, France; and Brussels, Belgium). The figure depicts the adjusted mortality of patients with VSAS (V_max >5 m/s, or MPG ≥60 mm Hg, or AVA <0.6 cm², or indexed AVA <0.4 cm²/m², n=365, 46.5%) compared with that of patients with severe AS not fulfilling any of the VSAS diagnostic criteria (n=420, 53.5%). Curves are adjusted for age, sex, EuroSCORE II, coronary artery disease, atrial fibrillation, LVEF, and AVR using a time‐dependent methodology (Tribouilloy et al, unpublished data, 2019). AS indicates aortic stenosis; AVA, aortic valve area; AVR, aortic valve replacement; HR, hazard ratio; LVEF, left ventricular ejection fraction; MPG, mean transaortic pressure gradient; VSAS, very severe aortic stenosis.