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Alterations in Cardiac Structure and Function Associated With Sub-Severe Aortic Stenosis Progression: The ARIC Study

Khaled Shelbaya1, Brian Claggett2, Pranav Dorbala2

  • 1University of Texas Southwestern Medical Center Dallas TX USA.

Journal of the American Heart Association
|January 14, 2026
PubMed

Insights

Early stages of aortic stenosis (AS) are linked to heart changes like increased left ventricular mass. Progression of AS worsens these cardiac alterations, especially with co-existing abnormalities.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Disease

Background:

  • American Heart Association and American College of Cardiology guidelines define 4 stages of aortic stenosis (AS).
  • Limited data exist on cardiac alterations in early (sub-severe) stages of AS.

Purpose of the Study:

  • To investigate cardiac structure and function in early AS stages.
  • To assess the impact of AS progression on cardiac measures.
  • To identify predictors of AS stage progression.

Main Methods:

  • Utilized data from the Atherosclerosis Risk in Communities (ARIC) study.
  • Classified participants by AS stages at two time points (V5 and V7) using echocardiography.
  • Employed multivariable regression models to analyze associations between AS stage, progression, and cardiac parameters.

Main Results:

  • Early AS stages (A and B) were associated with increased left ventricular wall thickness, mass, and filling pressures compared to Stage 0.
  • AS stage progression was linked to worsening of these cardiac measures (P<0.02).
  • The presence of both left ventricular and left atrial abnormalities increased the likelihood of AS stage progression (OR 1.7, P=0.009).

Conclusions:

  • Early AS stages are associated with cardiac remodeling and diastolic dysfunction.
  • AS stage progression leads to deterioration of cardiac structure and function.
  • Co-existing left ventricular and left atrial abnormalities predict a higher risk of early AS progression.
Abstract

Keywords:
ACC/AHA guidelinesaortic stenosisechocardiography

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