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Updated: Jul 17, 2026

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Prediction of the Individual Aortic Stenosis Progression Rate and its Association With Clinical Outcomes

Constantijn S Venema1, Kees H van Bergeijk1, Demetra Hadjicharalambous1

  • 1Department of Cardiology and Cardiothoracic Surgery, Heart Centre, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.

JACC. Advances
|June 28, 2024
PubMed

Insights

Progression of aortic stenosis varies. Faster aortic valve area decline predicts higher mortality and need for valve replacement, aiding personalized patient management.

Area of Science:

  • Cardiology
  • Echocardiography
  • Valvular Heart Disease

Background:

  • Aortic stenosis progression rates vary significantly among patients.
  • This variability complicates effective clinical follow-up and management strategies.

Purpose of the Study:

  • To identify key predictors of aortic stenosis progression rate.
  • To establish associations between progression rate and clinical outcomes.

Main Methods:

  • Retrospective longitudinal cohort study of 540 patients with moderate aortic stenosis.
  • Aortic valve area (AVA) progression calculated from serial echocardiograms.
  • Linear mixed-effects models and Cox regression analyzed predictors and outcomes.

Main Results:

  • Median AVA decrease was 0.09 cm²/y; median peak jet velocity increase was 0.17 m/s/y.
  • Rapid progression independently associated with increased all-cause mortality (HR: 1.77) and aortic valve replacement (HR: 3.44).
  • Older age, higher LV mass index, atrial fibrillation, and CKD predicted faster AVA decline.

Conclusions:

  • Aortic valve area decreases linearly in individual patients.
  • Faster progression correlates with increased mortality.
  • Clinical and echocardiographic factors predict individual progression, guiding follow-up intervals.
Abstract

Keywords:
aortic stenosisrisk predictionstructural heart diseasetranscatheter aortic valve replacementvalvular heart disease

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