Echocardiographic evaluation of thickened aortic valve and its relation to aortic stenosis and regurgitation

To elucidate the aging changes of human aortic valves and their relation to aortic regurgitation (AR) or stenosis (AS), consecutive echocardiographic examinations in 1601 subjects were carried out. These patients were prospectively divided into 5 groups: adolescence (< 20, N = 38); adulthood (20-39, N = 131); middle age (40-59, N-222); old age (60-79, N = 1194) and octogenarian (> = 80, N = 16). The incidence of thickened aortic valve (TAV), to be overall, was 29%. It was specifically 0% in the adolescence and adulthood, 15% in the middle age group, 35% in the elderly group and up to 69% in the octogenarian group. Among 307 subjects with TAV, the incidence of AR tended to increase with age, to be 31% in the 4th and 5th decades, 43% in the 6th and 7th decades and 62% in the 8th decades. The TAV existed more frequently over the noncoronary cusp (56%) than either left (22%) or right (22%) coronary cusp. In addition, the percentage of aortic stenosis and aortic regurgitation also tended to increase with age. In conclusion, TAV occurred more frequently at the noncoronary cusp than at the right or left coronary cusp. The incidence of TAV and the associated AS and AR tended to increase with age.