Moderate to severe aortic stenosis: Unraveling risk factors, clinical manifestations, and one-year cardiovascular outcomes

Abstract

BACKGROUND: Aortic stenosis (AS), a progressively degenerative cardiac condition, poses a substantial burden on morbidity and mortality. This study responds to the scarcity of comprehensive data on moderate to severe AS, focusing on risk factors, clinical manifestations, and one-year outcomes. METHODS: A retrospective cross-sectional study was conducted at Chamran Hospital (2021-2022) involving 97 patients with moderate-to-severe AS. Exclusion criteria included infiltrative diseases, radiotherapy history, cardiogenic shock, ejection fraction <20, fever, sepsis, and active infections. Data were collected using a standardized checklist with three sections: baseline demographics and risk factors, echocardiographic parameters, and outcomes (in-hospital events, surgical aortic valve replacement AVR, and one-year mortality). RESULTS: Among the patients, 29 (29.9%) were classified as moderate AS and the remainder were severe AS. Severe AS patients exhibited higher systolic pulmonary artery pressure (sPAP) and higher prevalence of moderate to severe diastolic dysfunction and three-vessel disease (3VD). Echocardiographic parameters such as mean pressure gradient (MG), peak velocity (PV), and high sPAP were related to the severity of AS (moderate to severe) by odds ratios of 1.13, 6.09, and 1.15 folds, respectively. CONCLUSION: AS imposes a significant burden of cardiovascular risk on the population. Patients with severe AS showed higher prevalence of increased filling pressures, moderate to severe diastolic dysfunction, 3VD, and higher sPAP compared with the moderate group, with no difference in clinical presentation and one-year outcome.