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May 1, 2026Journal of the American College of Cardiology120 citationsOpen Access

Moderate Aortic Stenosis in Patients With Heart Failure and Reduced Ejection Fraction

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Why the study?

The respective contribution of moderate AS versus HFrEF to patient outcomes remained unknown.

Does moderate aortic stenosis increase the risk of mortality and heart failure hospitalization in patients with HFrEF compared to HFrEF without AS?

Comparison

Moderate AS vs no AS matched 1:1

Design

Matched cohort study

Follow-up

Mean 2.9 ± 2.2 years

Authors

GJGuillaume JeanNMNicolas M. Van MieghemTGTea Gegenava

Discussion

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Member takes

Overview

Merits reassessment of isolated moderate AS; leaves open whether AVR confers survival benefit pending RCTs.

Structured PICO

Does moderate aortic stenosis increase the risk of mortality and heart failure hospitalization in patients with HFrEF compared to HFrEF without AS?

P
Population
524 patients with HFrEF (LVEF <50%), including 262 with moderate AS (aortic valve area >1.0 and <1.5 cm2; and peak aortic jet velocity >2 and <4 m/s) matched 1:1 with 262 patients with HFrEF and no AS.
I
Intervention
Moderate aortic stenosis (observational exposure)
C
Comparator
HFrEF with no AS (peak aortic jet velocity <2 m/s), matched 1:1 for sex, age, estimated glomerular filtration rate, NYHA functional class III to IV, presence of diabetes, LVEF, and body mass index.
O
Outcome
All-cause mortality and the composite of death and HF hospitalizationcomposite

In patients with HFrEF, the presence of moderate aortic stenosis is associated with a markedly increased risk of mortality and heart failure hospitalization, suggesting a potential survival benefit from transcatheter aortic valve replacement in this population.

Cite This Study

Jean et al. (2021) studied this question.

synapsesocial.com/papers/69f518f7a1676a5934daefc3https://doi.org/10.1016/j.jacc.2021.04.014
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