Incidence and outcomes in patients with moderate to severe aortic stenosis in the elderly
Liu Liangliang
Sun Zeyu
Zhang Yingqian
Wang Jing
Chen Yundai
Liu Changfu
Abstract：Objective This study explores the risk factors of all-cause mortality in elderly patients with moderate and severe aortic stenosis(AS)who receive conservative treatment.Methods 238 elderly patients with moderate to severe AS who visited the First Medical Center of the People's Liberation Army General Hospital from January 1,2021 to December 31,2022 were included.Clinical data,ultrasound findings,and treatment methods were collected from elderly patients with moderate to severe AS to identify risk factors for all-cause mortality using a multivariate Cox regression model.Results Multivariate Cox regression analysis showed that log N terminal pro B type natriuretic peptide(NT-proBNP)(HR=3.48;95％CI:1.41～9.19)was an independent predictor of 2-year all-cause death in moderate to severe AS patients receiving conservative treatment(P＜0.05).Among moderate to severe AS patients receiving conservative treatment,the all-cause mortality in patients with left ventricular end systolic diameter(LVESD)＞27.50 mm is significantly higher than that in the group with LVESD ≤ 27.50 mm(Z=-3.56,P＜0.010).All-cause mortality is significantly higher in moderate AS patients with combined left ventricular ejection fraction(LVEF)＜60％(37.93％vs.8.06％;HR=0.19;95％CI:0.07～0.54)or NT pro-BNP＞450 pg/ml(27.50％vs.10.34％;HR=0.31;95％CI:0.11～0.89).Conclusion The all-cause mortality is significantly reduced in patients with severe AS treated with aortic valve replacement(AVR),while the all-cause mortality is significantly increased in patients with moderate to severe AS combined with increased left ventricular end systolic diameter under conservative treatment.The survival rate of patients with moderate AS and either decreased LVEF or elevated NT-proBNP further declines,highlighting the need for close monitoring and timely evaluation to improve prognosis.
Keywords：Moderate to severe aortic stenosisThe elderlyLong-time prognosisRisk factors
Publication Date：2025-08-31
Online Publishing Date：2025-09-24(First online date of this platform, not the publication date of the document)
Pages：6( 565-570 )