Aortic Stenosis in Elderly : Determinant of Progression

Study Overview
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Brief Summary
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Aortic stenosis (AS) is AS is caused by calcium deposits in the aortic valve. Calcification is progressive and eventually leads to reduced leaflet motion with obstruction of the left ventricular outflow. The only treatment is surgery. There are evidences that AS is a regulated process with similarities to atherosclerosis but determinants of AS progression are unknown. The study aims at evaluating these determinants and more specifically the role of lipids, inflammation and platelet aggregation.

Detailed Description
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Aortic stenosis (AS) is the most common valvular disease and the second most common indication for cardiac surgery in Western countries. AS prevalence increases with age and with aging of the population, AS is a major public health problem. AS is due to calcium deposits within the aortic valve. Calcium deposit is progressive and eventually leads to reduced leaflet motion with obstruction of the left ventricular outflow. There is currently no effective medical therapy. Once the stenosis is severe and patients symptomatic, outcome is poor unless surgery (aortic valve replacement) is promptly performed. AS has long been considered as a passive and degenerative process. Recent data challenged this concept, showing that AS is an active and highly regulated process with some similarities to atherosclerosis. However, AS progression is highly variable from one individual to another and determinants of AS progression are poorly known. Their identification is crucial if we want to develop new medical strategies. The aims of the present study are to identify the determinants of AS progression and more specifically to evaluate the role of lipids, inflammation and platelet aggregation.

Official Title
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Aortic Stenosis in Elderly : Determinant of Progression. COFRASA (French Cohort)

Conditions
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Aortic Stenosis, Elderly Gravida

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 70 years AS with mean transmitral gradient > 10 mm Hg and aortic valve area < 2 cm2 No surgical indication Exclusion Criteria: Rheumatic or congenital AS Associated valvular disease grade ≥ 2/4 Indication for surgery (severe AS (aortic valve area < 1 cm2 or < 0.6 cm2/m2 of body surface area and symptoms or congestive heart failure or left ventricular ejection fraction < 50%) Renal insufficiency (creatinine clearance < 30 ml /min) Left ventricular outflow tract obstruction

Ages Eligible for Study
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Minimum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Progression of aortic stenosis |  | 2006 - 2017 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| AS related events |  | 2006 - 2017 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Elderly, Aortic stenosis