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{{CMG}}; '''Associate Editors-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@perfuse.org]; '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@perfuse.org]
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]; {{LG}}; {{USAMA}}  '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu]


==Overview==
==Overview==
Aortic stenosis is a major health problem primarily affecting older adults. As North American and European populations continue to live longer, aortic stenosis has major public health implications. The abnormalities of aortic valve morphology and function represent the most common cardiac-valve lesion in the elderly. The etiology of aortic stenosis is degenerative-calcific in the majority of patients.
[[Aortic stenosis]] is a major health problem that primarily affects the elderly. The majority of cases of aortic stenosis is due to [[calcific aortic valve disease|calcific]] [[degeneration]]. [[Aortic stenosis]] tends to affect approximately 1% of patients over the age of 65, 2% of patients over the age of 75, and 4% of patients over the age 85.<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-11}}</ref> As North American and European populations continue to live longer, aortic stenosis has major public health implications. Abnormalities of aortic valve morphology and function represent the most common valvular lesion in the elderly.<ref name="pmid8712130">{{cite journal| author=Iivanainen AM, Lindroos M, Tilvis R, Heikkilä J, Kupari M| title=Natural history of aortic valve stenosis of varying severity in the elderly. | journal=Am J Cardiol | year= 1996 | volume= 78 | issue= 1 | pages= 97-101 | pmid=8712130 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8712130  }} </ref>


==Prevalence==
==Epidemiology and Demographics==
Aortic stenosis is a common problem found predominantly in middle age to older adults. Less than 1% of all live births exhibit symptoms of severe aortic stenosis. Prevalence increases with age. Approximately 2% of people over the age of 65, 3% of people over age 75, and 4% of people over age 85 have the disorder. In North America and Europe, a linear relationship exists between an aging population and an increase in aortic stenosis.  
===Prevalence===
*The prevalence of aortic stenosis is approximately 3% in adults over 75 years.<ref name="pmid27582763">{{cite journal| author=Carità P, Coppola G, Novo G, Caccamo G, Guglielmo M, Balasus F | display-authors=etal| title=Aortic stenosis: insights on pathogenesis and clinical implications. | journal=J Geriatr Cardiol | year= 2016 | volume= 13 | issue= 6 | pages= 489-98 | pmid=27582763 | doi=10.11909/j.issn.1671-5411.2016.06.001 | pmc=4987417 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27582763  }} </ref>
*According to the Cardiovascular Health Study, the [[prevalence]] of aortic stenosis among patients more than 65 years of age is approximately 2% in the United States.<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-11}}</ref>
*Based on the results from the EuroHeart Failure survey programme, 4.8% of patients with [[acute coronary syndrome]] had significant valve disease, in particular [[calcific aortic valve disease|calcific]] [[aortic stenosis]].<ref name="pmid12633546">{{cite journal |author=Cleland JG, Swedberg K, Follath F, Komajda M, Cohen-Solal A, Aguilar JC, Dietz R, Gavazzi A, Hobbs R, Korewicki J, Madeira HC, Moiseyev VS, Preda I, van Gilst WH, Widimsky J, Freemantle N, Eastaugh J, Mason J |title=The EuroHeart Failure survey programme-- a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis |journal=[[European Heart Journal]] |volume=24 |issue=5 |pages=442–63 |year=2003 |month=March |pmid=12633546 |doi= |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=12633546 |accessdate=2012-04-11}}</ref>


the aortic valve sclerosis (aortic valve thickening and calcification without pressure gradient) seem to affect about one fourth of adults over 65 years of age, while the aortic valve stenosis is present in 2–9% of general population over 65 years of age; an increased prevalence of both sclerosis and stenosis with aging (48% and 4% in those over 85 years) is observed. Furthermore, the number of the aortic valve procedures performed over the last 10 years is increasing if we consider the aortic valve replacement alone or combined with myocardial revascularization; mitral valve surgery seems to be constant in the same period <ref name="pmid3807436">{{cite journal| author=Passik CS, Ackermann DM, Pluth JR, Edwards WD| title=Temporal changes in the causes of aortic stenosis: a surgical pathologic study of 646 cases. | journal=Mayo Clin Proc | year= 1987 | volume= 62 | issue= 2 | pages= 119-23 | pmid=3807436 | doi= | pmc= | url= }} </ref>.
===Age===
The [[prevalence]] of [[aortic stenosis]] increases with age. Less than 1% of all live births exhibit [[symptoms]] of [[severe aortic stenosis]].  Approximately 1% of patients over the age of 65, 2% of patients over the age of 75, and 4% of patients over the age of 85 have [[aortic stenosis]].<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-11}}</ref><ref name="pmid8459080">{{cite journal |author=Lindroos M, Kupari M, Heikkilä J, Tilvis R |title=Prevalence of aortic valve abnormalities in the elderly: an echocardiographic study of a random population sample |journal=[[Journal of the American College of Cardiology]] |volume=21 |issue=5 |pages=1220–5 |year=1993 |month=April |pmid=8459080 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0735-1097(93)90249-Z |accessdate=2012-04-11}}</ref>


In the Euro Heart Survey on [[Valvular Heart Disease]], aortic valve stenosis was the most common valve abnormality (33,9% and 46,6% in the overall group and surgical subgroup, respectively). The etiology of aortic stenosis was [[degenerative]]-calcific in the majority of patients (81,9%), while it was [[rheumatic]] in 11.2%, [[congenital]] in 5.6% and post-[[endocarditis]] in the remaining 1,3%. Among the 512 aortic stenosis patients who underwent valve replacement, 54,3% were elderly (more than 70 years), 80% had a preserved left ventricular systolic function (left ventricular [[ejection fraction]] >60%) and 85% had symptoms of [[heart failure]] ([[NYHA]] class II-IV) <ref name="pmid12831818">{{cite journal| author=Iung B, Baron G, Butchart EG, Delahaye F, Gohlke-Bärwolf C, Levang OW et al.| title=A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. | journal=Eur Heart J | year= 2003 | volume= 24 | issue= 13 | pages= 1231-43 | pmid=12831818 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12831818  }} </ref>.
===Gender===
Calcific degenerative aortic stenosis is more common in males.<ref>Townsend CM, et al. Sabiston Textbook of Surgery. 18th ed. Saunders; 2008:1841-1844.</ref>


In the Cardiovascular Health Study, the Doppler echocardiographic examination performed in 5621 subjects older than 65 year without prevalent cardiovascular disease at entry identified an aortic sclerosis (valve thickening and iperreflectivity) in 29% of overall population and an aortic stenosis (valve abnormalities and instantaneous pressure gradient >25 mmHg) in 2% <ref name="pmid9060903">{{cite journal| author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE et al.| title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study. | journal=J Am Coll Cardiol | year= 1997 | volume= 29 | issue= 3 | pages= 630-4 | pmid=9060903 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9060903 }} </ref>.
===Developed Countries===
 
In North America and Europe, a linear relationship exists between the increase in the [[incidence]] of [[aortic stenosis]] and the increase in aging population.<ref name="pmid25140960">{{cite journal| author=Otto CM, Prendergast B| title=Aortic-valve stenosis--from patients at risk to severe valve obstruction. | journal=N Engl J Med | year= 2014 | volume= 371 | issue= 8 | pages= 744-56 | pmid=25140960 | doi=10.1056/NEJMra1313875 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25140960 }} </ref>
As a disease, aortic stenosis has a high rate of [[morbidity]] and [[mortality]] resulting in a large personal and economic burden on affected populations. Without medical intervention, aortic stenosis can be a major health problem.
 
==Incidence==
The incidence of aortic stenosis is correlated to the age of the patient, primarily affecting older adults. Every year, approximately 29% of people older than 65 years and 37% of people older than 75 years become symptomatic of aortic stenosis.
 
==Sources==
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550260/


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[es:Estenosis aórtica]]
[[fr:Rétrécissement aortique]]
[[pl:Stenoza Aortalnej]]
[[pt:Estenose aórtica]]
[[ro:Stenoza Aortică]]
[[tr:Aort darlığı]]


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[[Category:Cardiac surgery]]
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[[Category:Valvular heart disease]]
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[[Category:Cardiology]]
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Latest revision as of 17:48, 3 March 2020



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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Mohammed A. Sbeih, M.D. [2]; Lakshmi Gopalakrishnan, M.B.B.S. [3]; Usama Talib, BSc, MD [4] Assistant Editor-In-Chief: Kristin Feeney, B.S. [5]

Overview

Aortic stenosis is a major health problem that primarily affects the elderly. The majority of cases of aortic stenosis is due to calcific degeneration. Aortic stenosis tends to affect approximately 1% of patients over the age of 65, 2% of patients over the age of 75, and 4% of patients over the age 85.[1] As North American and European populations continue to live longer, aortic stenosis has major public health implications. Abnormalities of aortic valve morphology and function represent the most common valvular lesion in the elderly.[2]

Epidemiology and Demographics

Prevalence

  • The prevalence of aortic stenosis is approximately 3% in adults over 75 years.[3]
  • According to the Cardiovascular Health Study, the prevalence of aortic stenosis among patients more than 65 years of age is approximately 2% in the United States.[1]
  • Based on the results from the EuroHeart Failure survey programme, 4.8% of patients with acute coronary syndrome had significant valve disease, in particular calcific aortic stenosis.[4]

Age

The prevalence of aortic stenosis increases with age. Less than 1% of all live births exhibit symptoms of severe aortic stenosis. Approximately 1% of patients over the age of 65, 2% of patients over the age of 75, and 4% of patients over the age of 85 have aortic stenosis.[1][5]

Gender

Calcific degenerative aortic stenosis is more common in males.[6]

Developed Countries

In North America and Europe, a linear relationship exists between the increase in the incidence of aortic stenosis and the increase in aging population.[7]

References

  1. 1.0 1.1 1.2 Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM (1997). "Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study". Journal of the American College of Cardiology. 29 (3): 630–4. PMID 9060903. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  2. Iivanainen AM, Lindroos M, Tilvis R, Heikkilä J, Kupari M (1996). "Natural history of aortic valve stenosis of varying severity in the elderly". Am J Cardiol. 78 (1): 97–101. PMID 8712130.
  3. Carità P, Coppola G, Novo G, Caccamo G, Guglielmo M, Balasus F; et al. (2016). "Aortic stenosis: insights on pathogenesis and clinical implications". J Geriatr Cardiol. 13 (6): 489–98. doi:10.11909/j.issn.1671-5411.2016.06.001. PMC 4987417. PMID 27582763.
  4. Cleland JG, Swedberg K, Follath F, Komajda M, Cohen-Solal A, Aguilar JC, Dietz R, Gavazzi A, Hobbs R, Korewicki J, Madeira HC, Moiseyev VS, Preda I, van Gilst WH, Widimsky J, Freemantle N, Eastaugh J, Mason J (2003). "The EuroHeart Failure survey programme-- a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis". European Heart Journal. 24 (5): 442–63. PMID 12633546. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  5. Lindroos M, Kupari M, Heikkilä J, Tilvis R (1993). "Prevalence of aortic valve abnormalities in the elderly: an echocardiographic study of a random population sample". Journal of the American College of Cardiology. 21 (5): 1220–5. PMID 8459080. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  6. Townsend CM, et al. Sabiston Textbook of Surgery. 18th ed. Saunders; 2008:1841-1844.
  7. Otto CM, Prendergast B (2014). "Aortic-valve stenosis--from patients at risk to severe valve obstruction". N Engl J Med. 371 (8): 744–56. doi:10.1056/NEJMra1313875. PMID 25140960.

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