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European Heart Journal Advance Access originally published online on April 13, 2005
European Heart Journal 2005 26(13):1252-1254; doi:10.1093/eurheartj/ehi295
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Management of asymptomatic aortic stenosis: how helpful is exercise testing?

Helmut Baumgartner*

Department of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Wien, Austria

* Corresponding author. Tel: +43 1 40400 4614; fax: +43 1 4081148. E-mail address: helmut.baumgartner@meduniwien.ac.at

This editorial refers to ‘Exercise testing to stratify risk in aortic stenosis’{dagger} by P. Das et al., on page 1309

The first 10% of the full text of this article appears below.

In contrast to symptomatic aortic stenosis (AS), asymptomatic AS has been shown to have a relatively good outcome even if it is haemodynamically severe.1,2 From the current data, it appears unlikely that the potential benefit can outweigh the risk of surgery and the long-term risk of prosthesis related complications in all patients. Surgery is, therefore, not generally recommended in AS before symptom onset.3 The management of asymptomatic AS has, nevertheless, remained controversial for several reasons: sudden death in truly asymptomatic patients has been reported to be extremely rare with an incidence of <1% per year.1,2 However, patients frequently do not present immediately when symptoms develop and mortality has been reported to be quite significant already within the following month after symptom onset.1 In addition, mortality rates up to 7% have been reported for symptomatic patients who must wait for surgery for several months.4 Finally, operative . . . [Full Text of this Article]

Exercise testing for risk stratification

Alternatives to exercise testing

Management of asymptomatic AS: current status


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Related articles in EHJ:

Exercise testing to stratify risk in aortic stenosis
Paul Das, Helen Rimington, and John Chambers
EHJ 2005 26: 1309-1313. [Abstract] [FREE Full Text]