ArticleEuropean heart journal2026
Subvalvular aortic stenosis in adults: clinical course and long-term outcomes.
Article in European heart journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Before the Valve: Localizing the Gradient in Complex LVOT Obstruction.JACC. Case reports · 2026Article
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14 authors.
Funding
Abstract
BACKGROUND AND
aimsThis study investigates the clinical course and long-term outcomes of adults with subvalvular aortic stenosis (SAS).
methodsAdults with SAS, prospectively registered in the Dutch Congenital Cor Vitia (CONCOR) registry between 2001-2019, were included. All-cause mortality, SAS (re-) operation, and cardiovascular events, including arrhythmias, heart failure, (re-)operation for aortic regurgitation (AR), were assessed. Longitudinal changes in echocardiographic peak velocity, interventricular septal thickness (IVST), and left ventricular posterior wall thickness (LVPW) were analysed using linear mixed-effects models. Differences in the history of SAS repair (operated/unoperated patients), isolated/non-isolated SAS, and sex were explored.
resultsOverall, 312 patients were included [age: 26.0 (interquartile range, IQR: 20.0-35.3) years, 68.3% history of SAS repair] with a median follow-up of 16 (IQR: 10-20) years (4423 patient-years). Unadjusted survival at 15 years was lower in the operated group compared to the unoperated group (P = .009) and no significant differences were observed between sexes (P = .083) or isolated/non-isolated SAS (P = .810). The cumulative incidence of (re-)operation for AR at 15 years was 7.6% (95% CI 4.7%-11.0%). The hazard of SAS repair during follow-up was higher in the unoperated group compared to the operated group [HR 0.2 (95% CI 0.1-0.5), P < .001], after correction for covariates. Peak velocity progression was 0.1 m/s (P = .357) during the first period and 0.3 m/s (P = .032) during the second (after ±10 years). No patient showed fast progression (≥0.3 m/s/year) in peak velocity. At baseline no evidence of left ventricular hypertrophy was observed, following IVST/LVPW criteria.
conclusionsSurvival of adult SAS patients with a history of SAS repair was substantially lower compared to the unoperated group, reflecting a potentially more severe SAS phenotype. Nevertheless, long-term clinical event rates were considerable. SAS remained stable, suggesting less echocardiographic follow-up may suffice, particularly in mild phenotypes without AR. Additionally, follow-up should focus on the clinical sequelae of SAS.
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