{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:32:32Z","timestamp":1793640752575,"version":"4.5.1"},"reference-count":40,"publisher":null,"issue":"1","license":[{"start":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/lib.ossn.ru\/jour\/about\/editorialPolicies#openAccessPolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Kardiologiia"],"abstract":"<jats:p>This thematic review focuses on recently proposed classification of stages in pronounced aortic stenosis based on the prevalence of extravalvular cardiac damage and its modified variant designed for asymptomatic patients. The review presents studies, which analyzed the predictive significance of the proposed classification. The use of this classification allows predicting the course of disease in patients with pronounced aortic stenosis in valve replacement. The classification is based on routinely used structural and functional echocardiographic signs with already proven predictive values with respect of adverse events in patients after aortic valve replacement. The review discusses limitations of the classification for pronounced aortic stenosis stages based on the prevalence of extravalvular cardiac damage.<\/jats:p>","DOI":"10.18087\/cardio.2021.1.n1024","type":"journal-article","created":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T04:21:35Z","timestamp":1615522895000},"page":"98-103","source":"Crossref","is-referenced-by-count":1,"title":["Classification of stages of severe aortic stenosis based on the prevalence of extravalvular heart damage"],"prefix":"10.68900","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9725-7528","authenticated-orcid":true,"given":"M. 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Pathophysiological Features and Remodeling of the Left Departments of Heart at a Stenosis of the Aortal Valve at Elderly Patients. Journal of Ural Medical Academic Science. 2016;14(2):126\u201333. DOI: 10.22138\/2500-0918-2016-14-2-126-133","DOI":"10.22138\/2500-0918-2016-14-2-126-133"},{"key":"ref39","unstructured":"Karpova N.Yu., Rashid M.A., Kazakova T.V., Shostak N.A. Aortic stenosis. Russian Medical Journal. 2014;22(2):162\u20135."},{"key":"ref40","unstructured":"Loginova I.Yu., Levitcheva E.N., Okuneva G.N., Semenova I.I. Stages of compensation of circulation in acquired aortic valve disease according to data of physical working capacity. 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