Age-dependent clinical and echocardiographic manifestations of aortic stenosis in an unselected, non-biased cohort

Abstract

Background: Age, clinical presentation and echocardiographic parameters are important factors in the decision on an individualized therapeutic strategy for patients with aortic stenosis (AS). Less is known about this information in a non-selected non-biased cohort. Methods: We performed a retrospective, systematic analysis of patients admitted to our hospital from 1/1/2014 to 1/6/2018 with the diagnosis of AS. We collected demographic, clinical and echocardiographic parameters. All patients were evaluated and treated in one single institution by experienced cardiologists. We classified patients into 4 age groups to compare the above-mentioned variables. Category A: Patients younger than 65 years, category B age between 65-74, category C age between 75-84, and category D patients older 85. Results: We included 321 adults with AS in our study. There was a significant correlation between the aortic valve area, aortic velocity (Vmax), aortic pressure gradients (PMax) and age. The AVA decreased, Vmax and PMax increased with age (P=0.001, P=0.042 and P=0.017, respectively). 74.1% of all patients were symptomatic, but there were no differences between the age categories (P=0.406). The incidence of cardiovascular comorbidities was high throughout all age categories. Forty-four point five percent of all patients had a coronary artery disease, but there were no differences between the age categories (P=0.221). Echocardiographic aspect of AS was similar in all age groups except the right ventricular pressure (RVP): RVP was significantly higher in patients younger than 65 years. Conclusions: Based on our results, we conclude that age is a weak parameter for making decisions about the optimal AS therapy. AVAs in AS decreases moderately with age. Age does not impact any clinical or echocardiographic parameters. Cardiovascular diseases and symptomatic AS are found in all age categories.