Treadmill Stress Test in Patients With Asymptomatic Severe Aortic Stenosis

How frequently do patients with asymptomatic severe aortic stenosis (AS) have a positive treadmill stress test (TST), what is the mortality rate over time for those patients, what are the predictors of a positive TST result, and what is the timing of aortic valve replacement (AVR) for patients with a positive TST? In this prespecified registry of 105 patients screened for the Evaluation of TAVR Compared to Surveillance for Patients With Asymptomatic Severe Aortic Stenosis (EARLY TAVR) randomized clinical trial, performing a TST in patients with asymptomatic severe AS was found to be safe and identified patients with symptoms and an indication for AVR. Among patients with a positive TST result, the 2-year mortality rate was low, and a subset remained untreated at 1 year. Prompt identification and referral for treatment of patients with symptoms or AVR indications is important.

Corresponding Author: Philippe Généreux, MD, Gagnon Cardiovascular Institute, Morristown Medical Center, 100 Madison Ave, Morristown, NJ 07960 (philippe.genereux@atlantichealth.org).

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