The stage of cardiac damage seen in a patient with aortic stenosis affects the long-term prognosis. The higher the stage the worse the survival.
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Findings
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Stage
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no significant damage outside of aortic valve
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0
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left ventricular hypertrophy, LVEF < 50% and/or severe diastolic dysfunction
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1
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left atrial damage and/or moderate to severe mitral regurgitation
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2
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moderate to severe tricuspid regurgitation and/or systolic pulmonary hypertension
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3
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moderate to severe right ventricular systolic dysfunction
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4
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where:
• Left ventricular hypertrophy is indicated by left ventricular mass > 95 per sq m for female; > 115 g per sq m for male.
• Severe diastolic dysfunction is indicated by E/e' ratio > 14.
• Left atrial damage is indicated by left atrial dilation > 34 mL per sq meter and/or atrial fibrillation.
• Systolic pulmonary hypertension: right ventricular systolic pressure >= 60 mm Hg.
