Prognostic Value of Combination of Hemodynamic Parameters in Asymptomatic Aortic Valve Stenosis—The COFRASA/GENERAC Study

Background: Whether risk-stratification in aortic valve stenosis (AS) should rely on a single hemodynamic parameter or a combination of hemodynamic parameters is still debated. We aimed to evaluate the prognostic value of mean pressure gradient (MPG), aortic valve area (AVA), and the dimensionless index (DI) in patients with AS and to test whether their combination provides additional prognostic information.Methods: We enrolled 319 asymptomatic patients with AS (90 mild, 173 moderate, and 56 severe AS). All patients were prospectively followed on a yearly basis and AS-related events (sudden death, heart failure, or new onset of AS-related symptoms) were collected.Results: After a mean follow-up of 3.1±1.7 years, an AS-related event occurred in 84 patients (26%). When considered in isolation, after adjustment for age, sex, history of coronary artery disease, valve anatomy, and left ventricular ejection fraction, each parameter (MPG, AVA, and DI) independently predicted the occurrence of AS-related ...