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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>.
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>.
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>.


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.
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.

Revision as of 18:19, 3 October 2011

Aortic Stenosis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Claudia P. Hochberg, M.D. [2], Abdul-Rahman Arabi, M.D. [3], Keri Shafer, M.D. [4], Mohammed A. Sbeih, M.D. [5]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [6]

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 implications on the overall personal health and economic burden. The abnormalities of aortic valve morphology and function represent the most common cardiac-valve lesion particularly in elderly. The etiology of aortic stenosis is degenerative-calcific in the majority of patients.

Prevalence

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.

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 [1].

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) [2].

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% [3].

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

  1. Passik CS, Ackermann DM, Pluth JR, Edwards WD (1987). "Temporal changes in the causes of aortic stenosis: a surgical pathologic study of 646 cases". Mayo Clin Proc. 62 (2): 119–23. PMID 3807436.
  2. Iung B, Baron G, Butchart EG, Delahaye F, Gohlke-Bärwolf C, Levang OW; et al. (2003). "A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease". Eur Heart J. 24 (13): 1231–43. PMID 12831818.
  3. Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE; et al. (1997). "Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study". J Am Coll Cardiol. 29 (3): 630–4. PMID 9060903.


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