We retrospectively evaluated 667 patients diagnosed with severe AS [Vmax ≥ 4 m/s, mean pressure gradient (MPG) ≥ 40 mmHg, or aortic valve area (AVA) ≤ 1.0 cm2] for the first time at our echocardiography laboratory, between December 2010 and February 2020. The following patients were excluded: (1) those with prosthetic valves, previous cardiac surgery, congenital heart disease, supravalvular or subvalvular AS or dynamic left ventricular outflow tract (LVOT) obstruction; (2) those with mitral stenosis (defined as functional mitral valve area ≤ 2.5 cm2; (3) those with AF at index echocardiogram or with previous history of AF; (4) those with poor acoustic window with suboptimal imaging of LA and (5) those with severe concomitant valvular lesions. Clinical, analytical and demographic baseline characteristics, including presence of coronary artery disease (CAD), cardiovascular risk factors, functional status, normal cognition and other comorbidities were collected from the hospital medical records.

The study was approved by the institutional scientific and bioethical committees and was performed in accordance with the Declaration of Helsinki.

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