title: Current state of symptomatic aortic valve stenosis in the Japanese elderly.
abstract: BACKGROUND
  There have been few reports regarding treatment selection and prognosis of symptomatic aortic valve stenosis (AS) in the elderly in Japan.
  
  
  RESULTS
  Sixty-one patients hospitalized between January 2000 and December 2007 for symptomatic severe AS were investigated. The average observation period was 27 months. Thirty-seven patients (61%) were diagnosed with AS for the first time on hospitalization. Thirty-six patients had onset of symptoms within 1 month before admission. Thirty-six patients received aortic valve replacement (group S) and 25 received medical therapy (group M). The patients in group M were older than those in group S (84.1 ± 5.3 years vs. 74.2 ± 4.6 years, P<0.001). Maximum flow velocity measured by echocardiography was lower in group M (4.5 ± 0.3 m/s vs. 4.9 ± 0.5 m/s, P<0 .01), but there was no difference in valve area between the 2 groups (0.62 ± 0.19 cm² vs. 0.57 ± 0.15 cm², P=0.12). One-year mortality rate derived from the Kaplan-Meier curve was higher in group M than group S (53.1% vs. 6.4%, respectively). On multivariate analysis, the only independent favorable prognostic factor was aortic valve replacement (HR: 0.02, 95%CI: 0.01-0.15, P<0.01).
  
  
  CONCLUSIONS
  Medical therapy is often selected for treatment of symptomatic AS in the elderly, but the prognosis is very poor. Symptomatic severe aortic stenosis should be treated surgically, or with transcatheter aortic valve implantation in cases with high surgical risk.
authors.affiliation: Department of Cardiology, Kameda Medical Center, Japan. mohno@kameda.jp
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ohno
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsumura
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Isobe
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D004562:Electrocardiography; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D019370:Observation; D011379:Prognosis