Abstract
Asymptomatic Severe Aortic Stenosis. A Journey of Patience or Proactivity?
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Background: According to ACC/AHA 2020 Guidelines, the asymptomatic severe aortic stenosis belongs to Stage C as per the staging classification of severe AS. There is a Class 1B recommendation for TAVI in Stage C2 in the case of a < 80 years old patient with a life expectancy of
Methods: This prospective Study was initiated in October 2021, was conducted for 18 months, and was completed in March 2023. This study is a prospective multicenter study of asymptomatic severe aortic stenosis, candidates for Conservative treatment, and Transcatheter aortic valve implantation (TAVI). The patients satisfying the inclusion criteria without exclusion criteria were randomized 1:1 to early TAVI or conventional treatment.
Results: The age group of the mean (years)+/- 2SD (78+/-7.8) in the TAVI Group and (77+/- 7.7) in the Watchful waiting group. The Aortic Valve area of the TAVI Group (mean) was 0.81cm2(062-0.95), and the watchful waiting group was 0,82cm2 (0.64-0.94)-follow-ups in every 3 months with clinical examination and echocardiography with LV-GLS, LVMI, and LAVI measurements. In 12 monthly follow-up periods, a LAVI regression of 15.48% was observed. Likewise, an LMVI Reduction of 11.83% was noted. Most importantly, LV-GLS improved by 22.79% in 12 months of the study period.
Conclusion: In conclusion, based on the findings of this investigation, transcatheter aortic valve implantation (TAVI) outperforms watchful waiting in patients with asymptomatic severe aortic stenosis (AS). TAVI significantly improves cardiac function parameters, reducing the risk of adverse events, including heart failure and major cardiovascular events, while improving the quality of life.
Keywords: Asymptomatic Severe Aortic Stenosis, TAVI, Watchful waiting, Left ventricle Mass Index (LVMI), Left Ventricle Global Longitudinal Strain (LV-GLS), Left Atrial Volume Index (LAVI)
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