Rate of progression of severity of valvular aortic stenosis in the adult.

In a retrospective study, 29 patients at least 20 years of age with known aortic stenosis are reported who had the peak systolic gradient (PSG) measured on at least two occasions without an intervening surgical procedure or episode of endocarditis. In these 29 patients, there were 31 intervals available for evaluation with a mean follow-up time of 43.5 months (1 week to 120 months). In 16 of the 31 intervals, the PSG increased by 50% or more and in 15, it did not. In the group where the PSG increased, the average rate of increase was 1.3 mm. Hg/month with the most rapid gradient increase at 3.8 mm. Hg/month. Progression to high gradient was correlated with the development of angina pectoris or left ventricular hypertrophy by voltage and ST-T wave changes. In this study, other symptoms were not helpful in predicting an increase in severity. It is still recommended, however, that any patient with aortic stenosis and the development of symptoms of congestive heart failure or exertional syncope should be suspected of having progressed to severe aortic stenosis and should be restudied.

[1]  B. Mccallister,et al.  Atypical presentations of patients with calcific aortic stenosis. Patients with normal ECG and patients with associated systemic hypertension. , 1970, JAMA.

[2]  H. Dodge,et al.  Quantitation of valvular insufficiency in man by angiocardiography. , 1963, American heart journal.

[3]  J. Greenfield,et al.  Left Ventricular Ejection Time in Valvular Aortic Stenosis , 1973, Circulation.

[4]  R GORLIN,et al.  Hydraulic formula for calculation of the area of the stenotic mitral valve, other cardiac valves, and central circulatory shunts. I. , 1951, American heart journal.

[5]  J. Pitha,et al.  Continuing disease process of calcific aortic stenosis. Role of microthrombi and turbulent flow. , 1977, The American journal of cardiology.

[6]  M. Sokolow,et al.  The ventricular complex in right ventricular hypertrophy as obtained by unipolar precordial and limb leads. , 1949, American heart journal.

[7]  Second Edition,et al.  Statistical Package for the Social Sciences , 1970 .

[8]  N. Shock,et al.  Changes in Cardiac Output with Age , 1955, Circulation.

[9]  W. Roberts,et al.  The Structure of the Aortic Valve in Clinically Isolated Aortic Stenosis: An Autopsy Study of 162 Patients Over 15 Years of Age , 1970, Circulation.

[10]  M. Mody,et al.  Serial hemodynamic observations in congenital valvular and subvalvular aortic stenosis. , 1975, American heart journal.

[11]  E. Braunwald,et al.  Congenital Aortic Stenosis: I. Clinical and Hemodynamic Findings in 100 Patients; II. Surgical Treatment and the Results of Operation , 1963 .

[12]  W. Friedman,et al.  Serial Hemodynamic Observations in Asymptomatic Children with Valvar Aortic Stenosis , 1971, Circulation.

[13]  E. Braunwald,et al.  Natural history of mild congenital aortic stenosis elucidated by serial hemodynamic studies. , 1972, The American journal of cardiology.