IMR Press / RCM / Volume 24 / Issue 10 / DOI: 10.31083/j.rcm2410293
Open Access Original Research
Echocardiographic Progression of Calcific Aortic Valve Disease in Patients with Preexisting Aortic Valve Sclerosis
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1 Heart Center, Department of Medicine II, University Hospital Bonn, 53127 Bonn, Germany
2 Heart Center, Department of Cardiology, University Hospital Cologne, 50937 Cologne, Germany
3 Heart Center, Department of Cardiology, University Hospital Düsseldorf, 40225 Düsseldorf, Germany
*Correspondence: jasmin.shamekhi@ukbonn.de (Jasmin Shamekhi)
Rev. Cardiovasc. Med. 2023, 24(10), 293; https://doi.org/10.31083/j.rcm2410293
Submitted: 8 March 2023 | Revised: 12 May 2023 | Accepted: 20 June 2023 | Published: 17 October 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: We aimed to evaluate echocardiographic parameters to predict calcific aortic valve disease (CAVD) progression. CAVD ranges from aortic valve sclerosis (ASc) with no functional impairment of the aortic valve to severe aortic stenosis (AS). It remains uncertain, which patients with ASc have a particularly high risk of developing AS. Methods: We included a total of 153 patients with visual signs of ASc and peak flow velocity (Vmax) below 2.5 m/s at baseline echocardiography. Progression of CAVD to AS was defined as an increase in Vmax 2.5 m/s with a delta of 0.1 m/s; stable ASc was defined as Vmax below 2.5 m/s and a delta <0.1 m/s. Finally, we compared clinical and echocardiographic parameters between these two groups. Results: The mean age at baseline was 73.5 (± 8.2) years and 66.7% were of male sex. After a mean follow-up of 1463 days, 57 patients developed AS, while 96 patients remained in the ASc group. The AS group showed significantly more calcification (p < 0.001) and thickening (p < 0.001) of the aortic valve cusps at baseline, although hemodynamics showed no evidence of AS in both groups (ASc group: Vmax 1.6 ± 0.3 m/s versus AS group: Vmax 1.9 ± 0.3 m/s; p < 0.001). Advanced calcification (odds ratio [OR]: 4.8, 95% confidence interval [CI]: 1.5–15.9; p = 0.009) and a cusp thickness >0.26 cm (OR: 16.6, 95% CI: 5.4–50.7; p < 0.001) were independent predictors for the development of AS. Conclusions: The acquisition of simple echocardiographic parameter may help to identify patients with particularly high risk of developing AS.

Keywords
calcific aortic valve disease
CAVD
aortic valve stenosis
aortic calcification
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Funding
SFB TRR Sonderforschungsbereich/Transregio] 259/1/Deutsche Forschungsgemeinschaft
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