Introduction: Aortic stenosis is the most common valvular heart disease, that occurs more frequent in men. Its prevalence increases with age and while it occurs rather rarely in people in their fifties (0.2%), it is quite an often comorbidity in octogenerians (9.8%). Around 2% people in their seventies suffer from moderate aortic stenosis. Pressure overload in patients with significant aortic stenosis starts a pathogenetic sequence, that causes structural and geometric remodeling of left ventricle and leads to dysfunction of mitral and tricuspid valve apparatus. (1-3)

Patients, Methods, and Results: Between October 2007 and October 2016, a total of 916 patients with aortic valve stenosis were hospitalized in University Hospital “Sveti Duh”, Zagreb. Patient age range was 44-95 years and 407 of them were men (44.4%). The most significant comorbidity was diabetes, present in over 36.1% of patients, and, interestingly enough, more often in women (53.2%). Hyperuricemia was also found to be a prevalent condition (52.5%). Most of patients had severe aortic stenosis (40.8%), while moderate and mild stenosis were present in 25.7% and 20.8% of patients respectively. Most of our patients had a combined valvular pathology. Aortic valve regurgitation was present in 17.7% patients, most often in those with severe stenosis (53.5%). Nearly half of patients (48.0%) had a significant mitral regurgitation, which correlated with the degree of aortic stenosis, most prominent being in patients with severe stenosis (48.9%). Only 4.8% of patients had mitral stenosis, which is due to a significant decrease in rheumatic fever incidence in our country during the last couple of decades. Combined mitral and aortic valve pathology was more often in women (53.6%). Nearly a quarter of patients (24.8%) had a tricuspid regurgitation, again most often present in patients with severe aortic stenosis (50%).

Conclusions: Aortic stenosis is not an isolated valvular disorder, but a complex syndrome, characterized by left ventricular remodeling, diastolic and systolic dysfunction, and other valvular disorders. If left untreated, aortic valve stenosis can cause advanced heart failure and a high mortality rate. It is important to notice that aortic stenosis represents a significant medical issue in modern societies, while also being a large financial burden on the society.