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Updated: Jul 5, 2026

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
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Differential determinants and prognostic value of aortic valve sclerosis over carotid atherosclerosis

Minjeong Kim1, Jiwon Seo2, In-Soo Kim2

  • 1Division of Cardiology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.

International Journal of Cardiology
|January 13, 2025
PubMed

Insights

Aortic valve sclerosis (AVS) predicts cardiovascular events and heart failure. However, AVS is a surrogate marker for vascular atherosclerosis and left ventricular dysfunction, not an independent risk factor.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Atherosclerosis Research

Background:

  • Aortic valve sclerosis (AVS) is a progressive atherosclerotic disease linked to cardiovascular events (CVE).
  • The independence of AVS development and prognostic value from arterial atherosclerosis requires investigation.
  • This study evaluates AVS determinants and prognostic value alongside carotid atherosclerosis.

Purpose of the Study:

  • To determine the factors influencing aortic valve sclerosis (AVS) development.
  • To assess the prognostic significance of AVS for future cardiovascular events (CVE) and heart failure (HF).
  • To investigate the relationship between AVS, carotid atherosclerosis, and cardiovascular outcomes.

Main Methods:

  • 4688 patients underwent carotid ultrasonography and echocardiography.
  • Exclusion criteria included bicuspid aortic valve, rheumatic heart disease, overt aortic stenosis, and prior aortic valve replacement.
  • AVS was defined as thickened, hyper-echogenic aortic valve cusps with a peak pressure gradient <2.5 m/s.

Main Results:

  • 11% of patients had AVS, independently correlated with age, diabetes, low HDL, and carotid plaques.
  • AVS was associated with atherosclerotic CVE (acute coronary syndromes, all-cause death) and future heart failure (HF) admissions.
  • AVS predicted atherosclerotic CVE independently of age and sex, but this association was attenuated by carotid plaques. HF admissions were linked to LV systolic and diastolic dysfunction.

Conclusions:

  • Aortic valve sclerosis (AVS) is a prognostic marker for future cardiovascular events (CVE) and heart failure (HF).
  • Atherosclerotic CVE risk is primarily mediated by vascular atherosclerosis.
  • Future HF admissions are mainly driven by left ventricular (LV) systolic and diastolic dysfunction, indicating AVS is a surrogate marker.
Abstract

Keywords:
Aortic valve sclerosisCardiovascular eventsCarotid atherosclerosisLeft ventricular function

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