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Temporal Trends in Etiology of Aortic Valvular Diseases for Patients Undergoing Surgical Valve Replacement: A Report

Kisaki Amemiya1, Hatsue Ishibashi-Ueda1,2, Yoshihiko Ikeda1

  • 1Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan.

Pathology International
|April 17, 2025
PubMed

Insights

Calcific aortic valve stenosis is increasing in Japan. Over 40 years, chronic rheumatic disease decreased while bicuspid and degenerative calcific aortic valve changes rose significantly.

Area of Science:

  • Cardiovascular Pathology
  • Epidemiology
  • Valvular Heart Disease

Background:

  • Aortic valvular disease encompasses various conditions, with a notable rise in calcific aortic valve stenosis.
  • Understanding etiological trends is crucial for managing this growing health concern.

Purpose of the Study:

  • To analyze the changing pathological characteristics and etiological trends of aortic valvular disease over four decades in Japan.
  • To investigate the increasing prevalence of calcific aortic valve stenosis and its potential link to atherosclerosis.

Main Methods:

  • Retrospective analysis of 4508 patients with aortic valvular disease from 1978 to 2022.
  • Categorization of resected aortic valves by etiology: congenital bicuspid, chronic rheumatic, infective endocarditis, degenerative calcific, and myxoid changes.
  • Trend analysis across four distinct time periods to identify significant shifts in disease prevalence.

Main Results:

  • Significant decrease in chronic rheumatic disease proportion (47% to 14%).
  • Substantial increase in congenital bicuspid valve cases (8% to 24%) and degenerative calcific change (4% to 27%).
  • Marked rise in aortic stenosis, particularly associated with degenerative calcific aortic valve changes.

Conclusions:

  • The etiology of aortic valvular disease in Japan has shifted significantly over 40 years.
  • Degenerative calcific aortic valve changes, potentially linked to atherosclerosis and dyslipidemia, are increasingly driving aortic stenosis.
  • These findings highlight the evolving landscape of valvular heart disease and necessitate updated clinical and research focus.

Keywords:
Japanaortic stenosisaortic valvular diseaseatherosclerosisetiologypathologytrend

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