This study investigates the clinical course of patients with moderate aortic stenosis (AS) who also have evidence of heart failure, as indicated by elevated brain natriuretic peptide (BNP) levels. The study is a single-center, retrospective cohort analysis of 332 patients with elevated BNP, comparing 165 patients with moderate AS to 167 controls without mild AS. The primary outcome was a composite endpoint of all-cause hospitalizations and all-cause mortality. Key findings include: - Patients with moderate AS had significantly higher rates of the primary composite endpoint compared to the control group, both in univariate and adjusted analyses. - Moderate AS was associated with a 1.41 times higher rate of all-cause hospitalizations per patient-year of follow-up. - Moderate AS was an independent predictor of all-cause hospitalizations, regardless of left ventricular ejection fraction (LVEF). - Moderate AS was significantly associated with higher all-cause hospitalization rates in both heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). The study concludes that moderate AS in conjunction with elevated BNP portends a significantly worse prognosis and should be closely monitored. The findings highlight the need for further research on the efficacy and safety of transcatheter aortic valve replacement (TAVR) in this population.This study investigates the clinical course of patients with moderate aortic stenosis (AS) who also have evidence of heart failure, as indicated by elevated brain natriuretic peptide (BNP) levels. The study is a single-center, retrospective cohort analysis of 332 patients with elevated BNP, comparing 165 patients with moderate AS to 167 controls without mild AS. The primary outcome was a composite endpoint of all-cause hospitalizations and all-cause mortality. Key findings include: - Patients with moderate AS had significantly higher rates of the primary composite endpoint compared to the control group, both in univariate and adjusted analyses. - Moderate AS was associated with a 1.41 times higher rate of all-cause hospitalizations per patient-year of follow-up. - Moderate AS was an independent predictor of all-cause hospitalizations, regardless of left ventricular ejection fraction (LVEF). - Moderate AS was significantly associated with higher all-cause hospitalization rates in both heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). The study concludes that moderate AS in conjunction with elevated BNP portends a significantly worse prognosis and should be closely monitored. The findings highlight the need for further research on the efficacy and safety of transcatheter aortic valve replacement (TAVR) in this population.