Patient screening for early detection of aortic stenosis (AS)—review of current practice and future perspectives

Abstract

In Europe, approximately one million people over 75 years suffer from severe aortic stenosis (AS), one of the most serious and most common valve diseases, and this disease burden is increasing with the aging population. A diagnosis of severe symptomatic AS is associated with an average life expectancy of 2-3 years and necessitates a timely valve intervention. Guidelines for valve replacement therapy have been established but only a proportion of patients with symptomatic AS actually receive this life-saving treatment. The decision for valve intervention in asymptomatic patients with severe AS is often more challenging and likely results in fewer patients receiving treatment in comparison to their symptomatic counterparts. This article reviews the epidemiology and clinical manifestations of AS, the associated economic burden of AS to the healthcare system, the diagnosis of AS and the possible mechanisms for the introduction of routine screening in elderly patients. Elderly patients typically visit healthcare providers more frequently than younger patients, thereby providing increased opportunities for ad hoc AS screening and this, along with raising patient awareness of the symptoms of AS, has the potential to result in the earlier diagnosis and treatment of AS and increased patient survival.

Aortic valve stenosis awareness in Austria—results of a nationwide survey in 1001 subjects

“…All of the above indicate a significant burden of valvular heart disease in Aus- ; six different health conditions were provided for suggested health checks, ranking from 1-6 (highest-lowest priority) and mean score ranks are presented for each condition tria. As the majority of patients affected by aortic valve stenosis do not receive treatment due to underdiagnosis of their condition, patient awareness appears to be of utmost importance to improve care of valvular heart disease [10]. Our survey indicates a low level of patient knowledge on aortic valve stenosis in Austria (Fig.…”

Two Cases of One-stage Procedure of TAVI and CERAB

“…Aortic stenosis is the most common valve disease in the elderly. Specifically, 12.4% of subjects aged >75 years suffered from AS and 3.4% from severe AS [3]. At this age, the prevalence of AAA is even higher, as it occurs in approximately 5% of men over 50 years [4].…”

Cardiac imaging of aortic valve area from 26,142 UK Biobank participants reveal novel genetic associations and shared genetic comorbidity with multiple disease phenotypes

“…In adult cohorts AS is the most frequent valvular disease 2 , with prevalence estimates around 0.3-0.5% in the general population, and markedly higher estimates in older individuals (e.g., circa 7% in subjects >65-year old subjects) 3 . As the natural history of adult-onset AS involves a relatively asymptomatic course followed by declining health after symptoms appear [4][5][6][7] , there is a strong therapeutic potential for early detection of disease 8 .…”