Current European guidelines recommend AVR for selected patients with asymptomatic aortic stenosis, namely patients with left ventricular dysfunction, abnormal exercise test, indication for other cardiac surgery, very severe aortic stenosis (defined as peak aortic flow velocity > 5.5m/s), rapid progression (defined as an increase in peak aortic flow velocity ≥ 0.3 m/s per year), markedly elevated BNP levels (> threefold normal range) or severe pulmonary hypertension (defined as a systolic pulmonary artery pressure at rest > 60mmHg), all class IIa recommandations [1]. This evidence concerns the gene NPPB and aortic stenosis.