title: Prognosis of medically treated patients at least 80 years old with severe sclerotic aortic stenosis.
abstract: BACKGROUND
  The prevalence of severe sclerotic aortic stenosis (ScAS) in those at least ≧80 years old has been increasing in Japan; however, the prognosis of these Japanese patients without surgical treatment has not been reported.
  
  
  RESULTS
  Ninety consecutive patients with medically treated severe ScAS were prospectively studied. To assess further event-free survival rate (EFSR) from either cardiac (heart failure or cardiac death) events or noncardiac deaths, they were divided into three groups based on aortic valve area (AVA) at the initial diagnosis (group A: AVA≦0.6cm(2), group B: 0.6cm(2)<AVA≦0.8cm(2), and group C: 0.8cm(2)<AVA≦1.0cm(2)). In comparison, 73 consecutive patients ≧80 years old with moderate ScAS (group M: 1.0cm(2)<AVA≦1.5cm(2)) were also enrolled. The EFSR in group A was significantly lower than that in the other groups (p<0.05) while no difference was seen among the other groups although the EFSR from cardiac events in group B was lower than the moderate group (p<0.05). Multivariate analysis showed that the cardiac risk factors were AVA ≦0.6cm(2) and left ventricular ejection fraction (EF) ≦55%.
  
  
  CONCLUSIONS
  Since patients with AVA ≦0.6cm(2) have a significantly worse prognosis, more symptoms, and higher prevalence of cardiac events, early aortic valve replacement should be considered in this group. Furthermore, patients having AVA ranging from 0.6 to 0.8cm(2) have a worse prognosis in cardiac events compared to group M. In addition, EF ≦55% is another significant factor for cardiac events.
authors.affiliation: Division of Cardiology, Cardiovascular Center, Teine Keijinkai Hospital, Sapporo, Japan. Electronic address: dfwnoris@yahoo.co.jp.
authors.forename: Hironori
authors.initials: H
authors.lastname: Murakami
authors.affiliation: Division of Cardiology, Cardiovascular Center, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Haruki
authors.initials: H
authors.lastname: Sasaki
authors.affiliation: Division of Cardiology, Cardiovascular Center, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Sasaki
authors.affiliation: Division of Cardiology, Cardiovascular Center, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Hata
authors.affiliation: Division of Cardiology, Cardiovascular Center, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Sugimoto
authors.affiliation: Division of Cardiology, Cardiovascular Center, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yakabe
authors.affiliation: Division of Cardiology, Cardiovascular Center, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Hirokami
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002423:Cause of Death; D005260:Female; D006333:Heart Failure / Q000401:mortality; D006350:Heart Valve Prosthesis; D006801:Humans; D007564:Japan; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume
keywords: Aortic stenosis; Aortic valve replacement; Elderly; Prognosis