Cardiac damage stages at follow-up and subsequent clinical outcomes in patients with severe aortic stenosis.

Data on the impact of cardiac damage based on follow-up echocardiography at 1 year in patients with severe aortic stenosis (AS) are insufficient. The current study included 1991 patients with severe AS who underwent follow-up echocardiography at 1 year after the initial AVR strategy (n = 1211) and conservative management (n = 780) in the CURRENT AS Registry-2. In the initial AVR group, the higher adjusted risk for stage 1, 2, and 3 or 4 relative to stage 0 was not significant for the primary outcome (a composite of all-cause death or hospitalization for heart failure) (hazard ratio [HR] = 0.51, 95% confidence interval [CI] = 0.25-1.04; HR = 0.71, 95% CI = 0.39-1.29; and HR = 0.57, 95% CI = 0.22-1.48). Meanwhile, in the conservative management group, it was significant for the primary outcome (HR = 2.33, 95% CI = 0.99-5.52; HR = 2.89, 95% CI = 1.30-6.40; and HR = 6.44, 95% CI = 2.62-15). A significant association was observed between the initial treatment strategies and effects of cardiac damage stages at 1 year on the primary outcome (P interaction = 0.003). Cardiac damage stages based on follow-up echocardiography at 1 year were useful for prognostic stratification in patients who received conservative management, but not in those who underwent initial AVR. UMINID: UMIN000034169.