RESUMO
INTRODUCTION: The natural outcome of untreated severe symptomatic aortic stenosis in the elderly patient is extremely poor. In this analysis we studied the clinical, ultrasound and analytical variables, that could be associated with the vital prognosis in this patient sub-group. MATERIAL AND METHODS: A retrospective study of patients admitted to our hospital between 2004 and 2008 due to symptoms associated with the presence of a severe aortic stenosis and were not considered for surgery. Demographic, concomitant diseases, ultrasound (ejection fraction, transvalvular gradient, valve area) and laboratory analytical data (haemoglobin, creatinine, atrial natriuretic peptide) were analysed and the logistic euroscore was calculated. RESULTS: A total of 49 patients were included (73.5% women), with a mean age of 82.2±5.5 years. The median follow up was 396.0 days, interquartile range 99.5-731.0 days, with a mortality of 75.5%. In the multivariate analysis, only the left ventricular ejection fraction measured by ultrasound was an important predictor as regards life expectancy (EF 35-50%: HR 3.74, IC 95% CI; 1.11-12.65, P=0.034; EF<35%: HR 6.76, IC 95% CI; 1.86-24.52, p=0.004). CONCLUSION: The life expectancy of elderly patients with untreated severe symptomatic aortic stenosis is very limited, with a high mortality during the first year. The ejection fraction is significantly associated with the prognosis in these patients.
