Early aortic valve replacement improves exercise capacity in truly asymptomatic patients with severe aortic stenosis

Abstract Background Exercise capacity is a strong predictor of morbidity and mortality overall. In severe aortic stenosis (AS) ustained pressure overload during watchful waiting associated with LV structural functional deterioration impaired clinical outcome both pre- post valve replacement (AVR). The effect early surgical (SAVR) in asymptomatic patients AS normal left ventricular function on exercise unknown. Aim We investigated whether the AVR truly LVEF improves capacity. Methods This sub-analysis or AVATAR trial (NCT02436655), which international prospective randomized controlled that evaluated safety efficacy SAVR treatment AS, according to common criteria (valve area ≤1 cm2 jet velocity >4 m/s mean transaortic gradient ≥40 mm Hg), function. Patients underwent cardiopulmonary testing (supine bicycle, ramp protocol, 15 W/min) at baseline 12 months following randomization. who had positive visit were excluded. compared value workload (in WATs), VO2 max, AT, VE/VCO2 PETCO2 slope inclusion months. Results Total 157 (mean age, 67 years; 57% men) randomly allocated surgery (n=78) conservative (n=79). Mean Vmax group 70% 4.5m/s 69% 4.5m/s, respectively. After there was slight decrease values workload, slope, but without statistical significance. However operated showed significant increase (115.4±38.4 watts vs 104.8±42.2 inclusion, p=0.038) max (19.7±6.8 16.2±5.4 p=0.048), while VEVCO2 Conclusion Early improve ejection fraction Funding Acknowledgement Type funding sources: None.