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<p>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.</p> Graphical abstract <p></p>

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

  • 期刊论文

  • 发表日期：

    2026年5月26日

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  • Yasuaki Takeji,
  • Tomohiko Taniguchi,
  • Takeshi Morimoto,
  • Shinichi Shirai,
  • Takeshi Kitai,
  • Hiroyuki Tabata,
  • Nobuhisa Ohno,
  • Ryosuke Murai,
  • Kohei Osakada,
  • Koichiro Murata,
  • Masanao Nakai,
  • Hiroshi Tsuneyoshi,
  • Tomohisa Tada,
  • Masashi Amano,
  • Shin Watanabe,
  • Hiroki Shiomi,
  • Hirotoshi Watanabe,
  • Yusuke Yoshikawa,
  • Ryusuke Nishikawa,
  • Yuki Obayashi,
  • Ko Yamamoto,
  • Mamoru Toyofuku,
  • Shojiro Tatsushima,
  • Norio Kanamori,
  • Makoto Miyake,
  • Hiroyuki Nakayama,
  • Kazuya Nagao,
  • Masayasu Izuhara,
  • Kenji Nakatsuma,
  • Moriaki Inoko,
  • Takanari Fujita,
  • Masahiro Kimura,
  • Mitsuru Ishii,
  • Shunsuke Usami,
  • Fumiko Nakazeki,
  • Kiyonori Togi,
  • Yasutaka Inuzuka,
  • Kenji Ando,
  • Tatsuhiko Komiya,
  • Koh Ono,
  • Kenji Minatoya,
  • Takeshi Kimura,
  • Naritatsu Saito,
  • Takao Kato,
  • Toshiaki Toyota,
  • Eri Minamino-Muta,
  • Yasauki Takeji,
  • Tomoya Yoneda,
  • Nao Kaneko

摘要

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.

Graphical abstract